Mycobacterium tuberculosis is the cause of most cases of tuberculosis (TB) in Australia. Patients with TB should:

Bacterial confirmation of the diagnosis, and drug susceptibility testing, should be strenuously pursued, because of concerns about drug resistance.

Adequate adherence to antituberculous therapy is vital to:

Measures to improve adherence include comprehensive patient and family education (in the form of verbal and written information), close consistent follow-up, and provision of directly observed therapy (DOT). If problems with supply of antituberculous drugs arise, the state health department should be contacted.

For drug-sensitive infections, the failure rate of modern antituberculous treatment regimens should be less than 1% and the 5-year relapse rate less than 5%.

Individuals with a positive tuberculin skin test or TB-specific interferon-gamma release assay but no evidence of active TB may have latent tuberculous infection. Seek specialist advice in patients where the size of the tuberculin skin test may be modified by, for example, past BCG (Bacillus Calmette-Guerin) vaccine or immunodeficiency including HIV. Treatment of latent infection can reduce the incidence of progression to active disease, and a single drug can be used because the number of organisms involved is small. After active TB has been excluded, individuals with a positive tuberculin skin test or TB-specific interferon-gamma release assay who should be considered for this treatment are:

Monitor liver function as for treatment of active TB , and educate patients about the symptoms of hepatitis. For patients likely to be infected with an isoniazid-resistant organism, or in whom isoniazid cannot be used, seek expert advice.