I read with interest the article titled "Tuberculosis Testing: Physician Attitudes and Practice" by Dr Cheng and her colleagues and the accompanying "Editor's Note" by Dr DeAngelis, both published in the July 1996 issue of the Archives.1 It was also interesting to see another survey2 documenting poor compliance to the American Academy of Pediatrics' tuberculosis testing recommendations. What we need is a survey on why pediatricians and family practitioners do not adhere to the recommendations, which should lead to a rethinking of the recommendations themselves.
I am a fellow of the American Academy of Pediatrics and find most of its recommendations reasonable. However, the tuberculosis guidelines do not make clinical sense to me. First, the Mantoux test has never been clinically proved to be superior in the hands of the average office personnel because it is technically much more difficult to administer correctly. In fact, the Mono-Vacc (Pasteur
Cersonsky J. Tuberculosis Testing: Physician Attitudes and Practice. Arch Pediatr Adolesc Med. 1997;151(2):212. doi:10.1001/archpedi.1997.02170390102027