Moxifloxacin and pyrazinamide susceptibility testing in a complex case of multidrug-resistant tuberculosis.

NA Feasey; M Pond; D Coleman; AW Solomon; CA Cosgrove; R Delgado; PD Butcher; DA Mitchison; T Harrison; (2011) Moxifloxacin and pyrazinamide susceptibility testing in a complex case of multidrug-resistant tuberculosis. The international journal of tuberculosis and lung disease, 15 (3). pp. 417-420. ISSN 1027-3719 https://material-uat.leaf.cosector.com/id/eprint/1146
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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.

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