Impact of short-term exposure to fluoroquinolones on ofloxacin resistance in HIV-negative patients with tuberculosis.
METHODS
Seoul, Korea, a country with an intermediate tuberculosis (TB) burden and low prevalence of human immunodeficiency virus (HIV) infection.


OBJECTIVE
To determine the frequency of ofloxacin (OFX) resistance in Mycobacterium tuberculosis, and to assess whether short-term use of fluoroquinolones (FQNs) induces ofloxacin-resistant M. tuberculosis.


METHODS
The subject cohort consisted of 2788 patients with culture-confirmed TB with drug susceptibility testing data; only four were HIV-positive. The patients were divided into two groups: those who were or were not recently exposed to FQNs.


RESULTS
Of the 2788 isolates, the rates of OFX resistance were 1.1% and 8.5% in initially treated and retreated patients, respectively (P < 0.05). Of the 94 OFX-resistant isolates, 83 (88.3%) were multidrug-resistant (MDR). There was no difference in rates of OFX resistance throughout the study period, or between the FQN-exposed (1/39, 2.6%) and control groups (93/2749, 3.4%). The median duration of FQN treatment was 7 days (range 1-47 days). One OFX-resistant isolate in the FQN-exposed group was MDR.


CONCLUSIONS
The rate of OFX-resistant M. tuberculosis was low and stationary throughout the study period in Korea. Most OFX resistance was accompanied by MDR, and the frequency of OFX-resistant M. tuberculosis was low in subjects taking short-term FQNs.
Park
I N
IN
Division of Pulmonary & Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Hong
S B
SB
Oh
Y M
YM
Lim
C M
CM
Lee
S D
SD
Lew
W J
WJ
Koh
Y
Y
Kim
W S
WS
Kim
D S
DS
Kim
W D
WD
Shim
T S
TS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000494:pharmacology*; D018023:HIV Seronegativity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007723:Korea / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000494:pharmacology*; D015995:Prevalence
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D015242:Ofloxacin