In a randomized double-blind trial of 345 adults with suspected smear-negative or sputum-scarce pulmonary tuberculosis, three consecutive daily inductions with nebulized racemic salbutamol produced a higher combined smear-or-culture yield and fewer adverse events than 3% hypertonic saline. The single-center study evaluates specimen collection for diagnosis, not tuberculosis treatment outcomes.
Key findings
- The combined smear-or-culture yield was 18.0% with salbutamol versus 9.2% with hypertonic saline (p=0.043). Adverse events occurred in 9.8% versus 28.3% (p=0.034), chest tightness in 2.3% versus 8.1% (p=0.031), and rescue treatment for bronchospasm in 0% versus 13.3% (p
Why this matters globally
If replicated across settings, the approach could improve specimen yield for microbiological confirmation of tuberculosis in sputum-scarce patients while reducing induction-related adverse events.
Thai researcher contribution
Researchers from the Faculty of Medicine, Prince of Songkla University designed and conducted the trial at Songklanagarind Hospital, producing evidence directly grounded in Thai clinical practice.
Limitations to consider
This was a single-center study with enrollment in 2016-2019. Its outcomes concern smear/culture yield rather than faster diagnosis or improved treatment outcomes. Laboratory practice, patient mix, and drug availability may affect transferability, so the intervention should not yet be treated as universally superior.