Treatment of Tuberculosis using Fluoroquinolone

Submitted by sanyu about 6 months ago

Tuberculosis is becoming an obstacle in Uganda due to an increased number of people being infected with the virus. It also makes it one of the most important global problems which is becoming a major challenge to cure.

Multi-drug resistant tuberculosis (MDR-TB), resistance to Ioniazid and extensively drug resistance tuberculosis (XDR-TB) with additional resistance to the fluoroquinolones and injectable anti-tuberculosis medication, have all become emergencies.

There is an urgent need for new TB drugs to improve, shorten and simplify treatment of drug susceptible tuberculosis to improve treatment of TB clients who are intolerant to the current first line drugs and provide effective treatment for clients with latent tuberculosis infection.

Fluoroquinolone antibiotics have been shown to have bacterial activity in vitriol against mycobacterium tuberculosis and this has been confirmed in an animal models. They are rapidly absorbed and have high availability with oral administration. They are generally well tolerated over the extended time periods necessary for treatment of tuberculosis.

Some studies have produced different results. For example, a study by Moadebi found that clients with susceptible tuberculosis strains, substitution of therapy with a fluoquinolone did not improve cure rates of radiological improvements at eight weeks or failure at twelve months.

Substitution of older fluoroquinolone into regimen especially ciprofloxacin resulted into a higher rate of relapse and a longer time to sputum–culture conversions. So older Fluoroquinolone like ciprofloxacin have limited activities of tuberculosis treatment though newer fluoroquinolones may have potent sterilizing activity.

In this case fluoroquinolones at the moment should not be used in treatment of tuberculosis susceptible to first-line regimens. They may have an important role as substitute agents for those who are intolerant to one or more first line drugs.

In summary, the most significant role of fluoroquinolones currently is in treatment of multi-drug resistant tuberculosis (MDR-TB). Despite the limited number of randomized clinical trials in this area, the use of fluoroquinolone in treatment of tuberculosis is found to work effectively in a large case series.

Keywords: Fluoroquinolone MDR MDR-TB resistance TB tuberculosis XDR XDR-TB

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