Moxifloxacin and pyrazinamide susceptibility testing in a complex case of multidrug-resistant tuberculosis.
Feasey, NA;
Pond, M;
Coleman, D;
Solomon, AW;
Cosgrove, CA;
Delgado, R;
Butcher, PD;
Mitchison, DA;
Harrison, T;
(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://researchonline.lshtm.ac.uk/id/eprint/1146
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https://researchonline.lshtm.ac.uk/id/eprint/1146
Abstract
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.