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Home / The International Journal of Tuberculosis and Lung Disease, Volume 15, Number 3

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

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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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