Process for Discontinuation of Airborne Precautions for Pulmonary TB

The patient care unit should inform IPAC prior to discontinuing precautions

Discontinuation of Airborne precautions requires a physicians order

Patients suspected of having Pulmonary TB should remain on Airborne Precaution until they have met ALL of the following criteria:

• Minimum of 3 negative AFB

• Clinical improvement

• An alternate diagnosis (that explains the syndrome)

If AFBs were ordered, but after review attending physician no longer suspects PTB and doesn’t feel the patient needs to be on airborne precautions, the physician needs to:

• Clearly document his/her rationale in the chart

• Cancel any outstanding orders for AFB

• Consult IPAC physician if there are questions

If a physician is looking for non-tuberculosis mycobacterium in sputum for AFB (e.g. MAC), they need to:

• Clearly document his/her rationale in the chart

• Cancel any outstanding orders for AFB

Patients undergoing treatment for PTB need to remain on precautions until:

• Two weeks of documented treatment (review notes/MAR to confirm no missed doses or obvious factors affecting drug absorption (e.g. vomiting/diarrhea)

• Clinical improvement

• Three consecutive negative AFB sputum’s of good quality (with first specimen taken at 14 days post-treatment).