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Fluoroquinolone Use Spikes Risk of Resistant TB Strain

Last Updated: August 13, 2009.

The overall prevalence of fluoroquinolone-resistant Mycobacterium tuberculosis is low, but the risk of having it is greatly elevated for TB patients who were exposed to the common antibiotic for more than 10 days, especially if the exposure occurred two or more months prior to their diagnosis, according to a study in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

THURSDAY, Aug. 13 (HealthDay News) -- The overall prevalence of fluoroquinolone-resistant Mycobacterium tuberculosis (TB) is low, but the risk of having it is greatly elevated for TB patients who were exposed to the common antibiotic for more than 10 days, especially if the exposure occurred two or more months prior to their diagnosis, according to a study in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Rose A. Devasia, M.D., of the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues enrolled 640 people who had confirmed TB. Those with fluoroquinolone-resistant TB were identified, and outpatient exposure to fluoroquinolone in the 12 months before diagnosis was determined.

The researchers found that 116 people had been exposed to fluoroquinolone in the 12 months before diagnosis, including 54 with more than 10 days of exposure. Sixteen of the subjects had TB resistant to fluoroquinolone, seven of whom were among those with more than 10 days of fluoroquinolone exposure. In logistic regression analysis, exposure to more than 10 days of fluoroquinolone prior to diagnosis was strongly associated with fluoroquinolone resistance (odds ratio, 7.0). If the more than 10-day exposure occurred more than 60 days before the diagnosis, the risk of resistance was even higher (odds ratio, 17.0).

"Overall, fluoroquinolone resistance was relatively low. However, receipt of fluoroquinolones for more than 10 days, particularly more than 60 days before TB diagnosis, was associated with a high risk of fluoroquinolone-resistant TB," the authors write.

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