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DOT for all patients with smear-positive pulmonary TB in London?
  1. R D Barker1,
  2. J Glyn-Jones1,
  3. G Bothamley2
  1. 1Department of Respiratory Medicine, King’s College Hospital, London, UK
  2. 2East London Tuberculosis Services, Homerton University Hospital, London, UK
  1. Correspondence to:
 Dr R D Barker, Department of Respiratory Medicine, King’s College Hospital, London, UK;
 jack.barker{at}kingshc.nhs.uk

https://doi.org/10.1136/jech.57.3.231

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    Supervised drug taking is frequently seen as the answer to rising levels of tuberculosis. Djuretic et al advocate directly observed therapy (DOT) for all patients with smear-positive pulmonary tuberculosis in London.1 At first sight the experience of instituting DOT in New York City appears especially impressive, with a 21% reduction in case rates and 39% decrease in drug resistant isolates. However, these reductions occurred at the same time as close attention was paid to drug regimens, the use of drug combinations, increased staffing levels, and the payment …

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