This guideline covers preventing, identifying and managing latent and active tuberculosis (TB) in children, young people and adults. It aims to improve ways of finding people who have TB in the community and recommends that everyone under 65 with latent TB should be treated. It describes how TB services should be organised, including the role of the TB control board.

 Fluoroquinolone antibiotics: In January 2024, the MHRA published a Drug Safety Update on fluoroquinolone antibiotics. These must now only be prescribed when other commonly recommended antibiotics are inappropriate. NICE is assessing the impact of this warning on recommendations in this guideline.

In February 2024, in the section on preventing TB, we removed family history of TB in the past 5 years from the list of criteria for BCG vaccination in neonates in low-incidence areas, to align with the chapter on tuberculosis in the Green Book.

Recommendations

The guideline includes recommendations on:

Who is it for?

  • Healthcare professionals and TB multidisciplinary teams
  • Substance misuse services, prisons and immigration removal centres
  • Local government and commissioners
  • TB control boards, directors of public health and public health consultants
  • Public Health England and NHS England
  • Voluntary sector workers
  • People with TB and their carers

Is this guideline up to date?

We checked this guideline in January 2022 and it will be updated. The update will focus on improving adherence: case management including directly observed therapy and the use of video observed therapy.

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE guideline CG117 (March 2011) and NICE guideline PH37 (March 2012).

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)