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Moxifloxacin and pyrazinamide susceptibility testing in a complex case of multidrug-resistant tuberculosis [Case study]

Authors: Feasey, N. A.; Pond, M.1; Coleman, D.2; Solomon, A. W.3; Cosgrove, C. A.4; Delgado, R.5; Butcher, P. D.2; Mitchison, D. A.2; Harrison, T.4

Source: The International Journal of Tuberculosis and Lung Disease, Volume 15, Number 3, March 2011 , pp. 417-420(4)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

Multidrug-resistant tuberculosis (MDR-TB) is a public health problem of global concern. It is critical that drug susceptibility testing (DST) methods accurately predict clinical response. We present a patient with a challenging case of MDR-TB with additional resistance to quinolones and pyrazinamide. Treatment with a regimen including high-dosage moxifloxacin, based on additional genotypic and phenotypic DST, produced excellent results. This case highlights the possibility of treatment with high-dose fluoroquinolones despite apparent bacterial resistance to these agents. Improved DST methods are necessary for both agents. Development of genotypic approaches may offer a susceptibility profile rapidly, enabling early introduction of individualised treatments.

Keywords: fluoroquinolones; multidrug-resistant; pyrazinamide; tuberculosis

Document Type: Short Communication

Affiliations: 1: Centre for Infection, Department of Cellular and Molecular Medicine, St George's University of London, London, UK; and Health Protection Agency Regional Microbiology Network, London, UK 2: Centre for Infection, Department of Cellular and Molecular Medicine, St George's University of London, London, UK 3: Clinical Infection Unit, St George's Hospital National Health Service Trust, Tooting, UK; and Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK 4: Centre for Infection, Department of Cellular and Molecular Medicine, St George's University of London, London, UK; and Clinical Infection Unit, St George's Hospital National Health Service Trust, Tooting, UK 5: Department of Medical Microbiology, St George's Hospital National Health Service Trust, Tooting, UK

Publication date: March 1, 2011

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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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