Switching from expectorated to induced sputum cultures for tuberculosis diagnosis reduces cost without increasing risk

Active pulmonary tuberculosis testing with 3 expectorated sputa can increase isolation days and expenditures compared with 1 induced sputum. Six-month retrospective and prospective chart reviews were conducted, and a screening algorithm was phased into 2 hospital sites. With induced sputum testing, isolation decreased from 7 to 4 days (interquartile range, 4-3, P  = .0135), and there was a cost savings of $7,275 per case, with no added harm.