Yıl: 2016 Cilt: 18 Sayı: 2 Sayfa Aralığı: 111 - 115 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic

Öz:
Objective: Inelaborate use of new quinolones with strong anti-tuberculosis (TB) activity leads to difficulty in diagnosis and more importantly, quinolone-resistant Mycobacterium tuberculosis. We aimed to determine the frequency of quinolone use in patients who were referred to our hospital for suspected TB and to evaluate the association between quinolone use and different clinical laboratory parameters.Methods: Between November 15 and December 15, 2013, all patients who were admitted to the TB outpatient clinic with no previous diagnosis of TB were included in this study. Demographic and clinical laboratory findings and history of antibiotic use were recorded. Patients' quinolone use were questioned by showing fluoroquinolone antibiotic boxes' photographs available on the market. The departments of the doctors who prescribed quinolones were recorded.Results: The mean age of 179 patients included in the study was 37±16 (15-89) years. Among these, 113 patients (63.1%) were male. Seventy five patients (41.9%) were diagnosed as tuberculosis according to the clinical-radiological and/or bacteriological findings. Of 179 patients, 58.1% (n=104) had been prescribed antibiotics for current complaints before referral to our clinic. Sixteen patients (15%) had been recommended fluoroquinolones. Fluoroquinolones were prescribed by seven internal medicine specialists, five pulmonologists, three emergency medicine specialists, and one family medicine practitioner. Among 16 fluoroquinolones prescribed, nine were moxifloxacin, four were levofloxacin, and three were gemifloxacin. Quinolone use revealed a significant inverse relationship only with the presence of hemoptysis (p=0.04).Conclusion: Besides increased educational activities regarding the rational use of antibiotics in recent years, the quinolone group of antibiotics is still prescribed for suspected TB cases. To avoid quinolone-resistant M. tuberculosis strains, further education is required.
Anahtar Kelime:

Konular: Solunum Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • World Health Organization (WHO). Global Tuberculosis Report 2015. (Ac- cess date:07.03.2016) Available from: URL: http://www.who.int/tb/publi- cations/global_report/en/
  • Ruiz-Serrano MJ, Alcalá L, Martínez L, Díaz M, Marín M, González-Abad MJ, et al. In vitro activities of six fluoroquinolones against 250 clinical iso- lates of Mycobacterium tuberculosis susceptible or resistant to first-line antituberculosis drugs. Antimicrob Agents Chemother 2000; 44: 2567-8. [CrossRef]
  • Gillespie SH. The role of moxifloxacin in tuberculosis therapy. Eur Respir Rev 2016; 25: 19-28. [CrossRef]
  • Gillespie SH, Crook AM, McHugh TD, Mendel CM, Meredith SK, Murray SR, et al; REMoxTB Consortium. Four-month moxifloxacin-based regi- mens for drug-sensitive tuberculosis. N Engl J Med 2014; 371: 1577-87. [CrossRef]
  • Jindani A, Harrison TS, Nunn AJ, Phillips PP, Churchyard GJ, Charalam- bous S, et al; RIFAQUIN Trial Team. High-dose rifapentine with moxi- floxacin for pulmonary tuberculosis. N Engl J Med 2014; 371: 1599-608. [CrossRef]
  • Merle CS, Fielding K, Sow OB, Gninafon M, Lo MB, Mthiyane T, et al; OFLOTUB/Gatifloxacin for Tuberculosis Project. A four-month gatifloxa- cin-containing regimen for treating tuberculosis. N Engl J Med 2014; 371: 1588-98. [CrossRef]
  • Wang JY, Hsueh PR, Jan IS, Lee LN, Liaw YS, Yang PC, et al. Empirical treat- ment with a fluoroquinolone delays the treatment for tuberculosis and is associated with a poor prognosis in endemic areas. Thorax 2006; 61: 903-8. [CrossRef]
  • Dooley KE, Golub J, Goes FS, Merz WG, Sterling TR. Empiric treatment of community-acquired pneumonia with fluoroquinolones, and delays in the treatment of tuberculosis. Clin Infect Dis 2005; 34: 1607-12. [CrossRef]
  • Nuermberger EL, Yoshimatsu T, Tyagi S, Williams K, Rosenthal I, O'Brien RJ, et al. Moxifloxacin-containing regimens of reduced duration produce a stable cure in murine tuberculosis. Am J Respir Crit Care Med 2004; 170: 1131-4. [CrossRef]
  • Gosling RD. The bactericidal activity of moxifloxacin in patients with pulmonary tuberculosis. Am J Respir Crit Care Med 2003; 168: 1342-5. [CrossRef]
  • Conde MB, Efron A, Loredo C, De Souza GR, Graça NP, Cezar MC, et al. Moxifloxacin versus ethambutol in the initial treatment of tuberculosis: a double-blind, randomised, controlled phase II trial. Lancet 2009; 373: 1183-9. [CrossRef]
  • Aubry A, Veziris N, Cambau E, Truffot-Pernot C, Jarlier V, Fisher LM. Novel gyrase mutations in quinolone-resistant and hypersusceptible clinical isolates of Mycobacterium tuberculosis: functional analysis of mutant enzymes. Antimicrob Agents Chemother 2006; 50: 104-12. [CrossRef]
  • Malik S, Willby M, Sikes D, Tsodikov OV, Posey JE. New insights into fluo- roquinolone resistance in Mycobacterium tuberculosis: functional genetic analysis of gyrA and gyrB mutations. PLoS ONE 2012; 7: e39754. [CrossRef]
  • Li J, Gao X, Luo T, Wu J, Sun G, Liu Q, et al. Association of gyrA/B mutations and resistance levels to fluoroquinolones in clinical isolates of Mycobac- terium tuberculosis. Emerg Microbes Infect 2014; 3: e19. [CrossRef]
  • Kam KM, Yip CW, Cheung TL, Tang HS, Leung OC, Chan MY. Stepwise decrease in moxifloxacin susceptibility amongst clinical isolates of mul- tidrug-resistant Mycobacterium tuberculosis: correlation with ofloxacin susceptibility. Microb Drug Resist 2006; 12: 7-11. [CrossRef]
  • Rustomjee R, Lienhardt C, Kanyok T, Davies GR, Levin J, Mthiyane T, et al; Gatifloxacin for TB (OFLOTUB) study team. A Phase II study of the steril- izing activities of ofloxacin, gatifloxacin and moxifloxacin in pulmonary tuberculosis. Int J Tuberc Lung Dis 2008; 12: 128-38.
  • Ginsburg AS, Grosset JH, Bishai WR. Fluoroquinolones, tuberculosis, and resistance. Lancet Infect Dis 2003; 3: 432-42. [CrossRef]
  • Yoon YS, Lee HJ, Yoon HI, Yoo CG, Kim YW, Han SK, et al. Impact of fluoro- quinolones on the diagnosis of pulmonary tuberculosis initially treated as bacterial pneumonia. Int J Tuberc Lung Dis 2005; 9: 1215-9.
  • Tan CK, Lai CC, Liao CH, Chou CH, Hsu HL, Huang YT, et al. Comparative in vitro activities of the new quinolone nemonoxacin (TG- 873870), gemi- floxacin and other quinolones against clinical isolates of Mycobacterium tuberculosis. J Antimicrob Chemother 2009; 64: 428-9. [CrossRef]
  • Lai CC, Tan CK, Huang YT, Chou CH, Hung CC, Yang PC, et al. Extensively drug-resistant Mycobacterium tuberculosis during a trend of decreasing drug resistance from 2000 through 2006 at a Medical Center in Taiwan. Clin Infect Dis 2008; 47: 57-63. [CrossRef]
  • Kim SY, Yim JJ, Park JS, Park SS, Heo EY, Lee CH, et al. Clinical effects of gemifloxacin on the delay of tuberculosis treatment. J Korean Med Sci 2013; 28: 378-82. [CrossRef]
  • Long R, Chong H, Hoeppner V, Shanmuganathan H, Kowalewska-Gro- chowska K, Shandro C, et al. Empirical treatment of community-acquired pneumonia and the development of fluoroquinolone-resistant tubercu- losis. Clin Infect Dis 2009; 48: 1354-60. [CrossRef]
APA Iliaz S, ÖNÜR S, GÖNENÇ ORTAKÖYLÜ M (2016). Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. , 111 - 115.
Chicago Iliaz Sinem,ÖNÜR Seda Tural,GÖNENÇ ORTAKÖYLÜ Mediha Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. (2016): 111 - 115.
MLA Iliaz Sinem,ÖNÜR Seda Tural,GÖNENÇ ORTAKÖYLÜ Mediha Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. , 2016, ss.111 - 115.
AMA Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. . 2016; 111 - 115.
Vancouver Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. . 2016; 111 - 115.
IEEE Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M "Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic." , ss.111 - 115, 2016.
ISNAD Iliaz, Sinem vd. "Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic". (2016), 111-115.
APA Iliaz S, ÖNÜR S, GÖNENÇ ORTAKÖYLÜ M (2016). Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. Solunum, 18(2), 111 - 115.
Chicago Iliaz Sinem,ÖNÜR Seda Tural,GÖNENÇ ORTAKÖYLÜ Mediha Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. Solunum 18, no.2 (2016): 111 - 115.
MLA Iliaz Sinem,ÖNÜR Seda Tural,GÖNENÇ ORTAKÖYLÜ Mediha Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. Solunum, vol.18, no.2, 2016, ss.111 - 115.
AMA Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. Solunum. 2016; 18(2): 111 - 115.
Vancouver Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic. Solunum. 2016; 18(2): 111 - 115.
IEEE Iliaz S,ÖNÜR S,GÖNENÇ ORTAKÖYLÜ M "Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic." Solunum, 18, ss.111 - 115, 2016.
ISNAD Iliaz, Sinem vd. "Evaluating Fluoroquinolone Use in Patients Admitted to the Tuberculosis Outpatient Clinic". Solunum 18/2 (2016), 111-115.