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Free Content Impact of fluoroquinolones on the diagnosis of pulmonary tuberculosis initially treated as bacterial pneumonia

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OBJECTIVE: The excellent in vitro activity of fluoroquinolones against Mycobacterium tuberculosis has raised concerns about the delayed diagnosis of pulmonary tuberculosis (PTB) initially misdiagnosed as pneumonia. The aim of this study was to assess the effect of empiric fluoroquinolone therapy on delays in diagnosis in patients with PTB initially misdiagnosed as bacterial pneumonia.

DESIGN: Patients with PTB initially treated as having community-acquired pneumonia and treated with fluoroquinolones for more than 5 consecutive days, from January 2000 to December 2004, were enrolled. As a control group, TB patients initially treated with non-fluoroquinolone antibiotics were enrolled. We reviewed the clinical data and compared treatment responses between the two groups.

RESULTS: Nine patients in the fluoroquinolone group and 19 patients in the non-fluoroquinolone group were enrolled. In the fluoroquinolone group, eight patients (89%) improved clinically or radiographically, whereas only eight patients (42%) in the non-fluoroquinolone group improved (P = 0.04). The delay in initiation of anti-tuberculosis medication was longer in the fluoroquinolone group than in the non-fluoroquinolone group (43.1 ± 40.0 vs. 18.7 ± 16.9 days, P = 0.04).

CONCLUSION: Delay in the initiation of anti-tuberculosis treatment is possible in patients administered fluoroquinolone and initially misdiagnosed as having bacterial pneumonia.
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Keywords: diagnosis; fluoroquinolone; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Republic of Korea 2: Department of Radiology and the Institute of Radiation Medicine, Seoul National University College of Medicine, Republic of Korea

Publication date: 2005-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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