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September 1, 1978

Who Should Treat Tuberculosis?

Author Affiliations

USAF US Air Force Medical Center Scott Scott Air Force Base, Ill; New Jersey Medical School Newark

JAMA. 1978;240(9):864. doi:10.1001/jama.1978.03290090058022

The closing of tuberculosis sanatoriums during recent years has placed the treatment of tuberculosis in many communities into the hands of physicians inexperienced in dealing with the disease. When this shift was originally advocated, no major problems were anticipated in view of the effective antituberculous medications available. However, many physicians, including some board-certified internists, failed to understand the basic principles involved in treating the disease. A recent study in this regard showed that more than 60% of a group of 130 tuberculosis patients were inappropriately treated by standard textbook criteria.1 The possible increasing incidence of the disease in some urban areas may relate to this inept management.2

The recently observed high incidence of drug resistance and particularly multiple drug resistances now being seen in ghetto populations may also reflect improper treatment.3 This turn of events should probably not be surprising because most medical schools offer little instruction