title: Is the delay in diagnosis of pulmonary tuberculosis related to exposure to fluoroquinolones or any antibiotic?
abstract: BACKGROUND
  Delays in diagnosis of tuberculosis (TB) have been associated with previous use of antibiotics, and in particular fluoroquinolones (FQ), for suspected pulmonary infections.
  
  
  METHODS
  We conducted a population-based cohort study with 2232 patients who had active TB between 1997 and 2006 (records obtained from the British Columbia Linked Health Databases). Patients with a record of an initial health care contact preceding the diagnosis of TB were identified for inclusion. Health care delay was defined as the time between initial health care contact and the initiation of anti-tuberculosis medication, and was compared between patients prescribed antibiotics and those not exposed to any antibiotics.
  
  
  RESULTS
  A total of 1544 patients were included. After adjusting for covariates, average health care delay for patients exposed to antibiotics was found to be significantly greater, by a factor of 2.10 (95%CI 1.80-2.44), with a median delay of 41 days in the antibiotic group compared to 14 days in the non-antibiotic group. Sex, age, foreign-born status and socio-economic status were non-significant factors. Health care delay increased with the number of antibiotic courses received, but not with the type of antibiotic.
  
  
  CONCLUSIONS
  Previous treatment with any antibiotic, and not only a FQ, is associated with a delay in TB diagnosis.
authors: University of British Columbia, Vancouver, British Columbia, Canada.
authors: M
authors: M
authors: Wang
authors: J M
authors: JM
authors: Fitzgerald
authors: K
authors: K
authors: Richardson
authors: C A
authors: CA
authors: Marra
authors: V J
authors: VJ
authors: Cook
authors: J
authors: J
authors: Hajek
authors: R K
authors: RK
authors: Elwood
authors: W R
authors: WR
authors: Bowie
authors: F
authors: F
authors: Marra
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001955:British Columbia; D015331:Cohort Studies; D057210:Delayed Diagnosis; D011307:Drug Prescriptions; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D024841:Fluoroquinolones