title: Increased resistance to ciprofloxacin and ofloxacin in multidrug-resistant mycobacterium tuberculosis isolates from patients seen at a tertiary hospital in the Philippines.
abstract: METHODS
  A hospital-based study at the Makati Medical Center, Makati City, Philippines, a hyperendemic area for tuberculosis (TB).
  
  
  OBJECTIVE
  To determine the susceptibility of Mycobacterium tuberculosis to ciprofloxacin and ofloxacin.
  
  
  METHODS
  Retrospective analysis of drug susceptibility tests (DST) of M. tuberculosis isolated from 1995-2000.
  
  
  RESULTS
  Resistance to ciprofloxacin was 26.8%, ofloxacin 35.3%, and multidrug resistance (MDR) was 17.2%. Of the MDR strains, 51.4% were resistant to ciprofloxacin and ofloxacin. Acquired resistance was significantly higher for all first-line drugs and for ciprofloxacin, but not for ofloxacin. A significant increase in resistance to ciprofloxacin and ofloxacin was noted compared to 1989-1994, while resistance to the firstline drugs was not significantly different.
  
  
  CONCLUSIONS
  Ciprofloxacin and ofloxacin are now a significantly less effective alternative therapy in tuberculosis, particularly MDR-TB, due to a selection pressure from their widespread use in the treatment of TB and possibly other infections in the community, which is hyperendemic for tuberculosis.
authors.affiliation: Tropical Disease Foundation, Makati Medical Center, Legaspi Village, Makati City, Philippines.
authors.forename: E R
authors.initials: ER
authors.lastname: Grimaldo
authors.forename: T E
authors.initials: TE
authors.lastname: Tupasi
authors.forename: A B
authors.initials: AB
authors.lastname: Rivera
authors.forename: M I
authors.initials: MI
authors.lastname: Quelapio
authors.forename: R C
authors.initials: RC
authors.lastname: Cardaño
authors.forename: J O
authors.initials: JO
authors.lastname: Derilo
authors.forename: V A
authors.initials: VA
authors.lastname: Belen
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003470:Culture Media; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D006761:Hospitals; D006801:Humans; D066298:In Vitro Techniques; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification*; D015242:Ofloxacin / Q000493:pharmacokinetics* / Q000627:therapeutic use; D010679:Philippines; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000890:Anti-Infective Agents; D003470:Culture Media; D002939:Ciprofloxacin; D015242:Ofloxacin