We assessed the quality of tuberculosis management practices in a predominantly rural state.Methods.
Medical records of persons reported to the Centers for Disease Control and Prevention (CDC) with the diagnosis of tuberculosis were audited; management practices were compared with guidelines from the American Thoracic Society (ATS) and CDC.Results.
We reviewed 207 records from 24 health districts in Kentucky. These records represented 30% of the cases reported to the CDC during the 17-month study. Tuberculosis was diagnosed by culture in 66% of patients; 12 different antibiotic regimens for antibiotic sensitive bacteria were prescribed; human immunodeficiency virus testing was documented in only 39%; monitoring for drug toxicity and bacteriologic cure was appropriate in <65%; directly observed therapy was used in only 38%, and only 23% of close contacts were reevaluated at 12 weeks.Conclusions.
Tuberculosis management practices in Kentucky fall short of ATS/CDC guidelines. Continuing quality-improvement efforts are warranted.