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Int. J. Tuberc. Lung Dis. · Mar 2011
Case ReportsMoxifloxacin and pyrazinamide susceptibility testing in a complex case of multidrug-resistant tuberculosis.
- N A Feasey, M Pond, D Coleman, A W Solomon, C A Cosgrove, R Delgado, P D Butcher, D A Mitchison, and T Harrison.
- Malawi Liverpool Wellcome Trust, Blantyre, Malawi. n_feasey@hotmail.com
- Int. J. Tuberc. Lung Dis. 2011 Mar 1;15(3):417-20.
AbstractMultidrug-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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