DOI: 10.36347/sjams.2018.v06i04.024

Pages: 1503-1506

With the rapid emergence of drug resistant bacilli, it has become important to get bacteriological confirmation of pulmonary TB in sputum smear negative patients. Sputum induction is simple and non-invasive, and may precludes the need for bronchoscopy. A prospective study was conducted among patients with smear-negative pulmonary TB with an objective to collect adequate sample of sputum with induction of sputum and compare sputum induction between nebulized N-acetyl cysteine (NAC), 0.9% normal saline (NS), and 3% hypertonic saline (HS). The consecutive 150 patients were taken fulfilling eligibility criteria and randomised in three groups and received nebulised 3% hypertonic saline, N-acetyl cysteine and 0.9% normal saline. There were 92(61.3%) male and 58 (38.6%) female in study population. The mean age of study group was 39.7 years (range 18-75). Sputum induction was successful in 125(83.3%) patients. Overall, 24.6% (n=37) patients were found positive on smear examination after sputum induction. Induction with 3% HS (n=50) was successful in 94% (n=47) patients while NAC and 0.9% NS induced sputum in 84% (n=42) and 72% (n=36) patients respectively. The percentage of smear positivity among successfully induced sputum was highest in 3% HS group (n=20/47, 42.5%). In conclusion, all the three agents can be used for sputum induction in sputum smear negative pulmonary TB but efficacy of 3% HS is better than other two agents.