title: [Evaluation of tuberculosis treatment including levofloxacin (LVFX) in cases who could not continue standard regimen].
abstract: OBJECTIVE
  The purpose of this study was to evaluate tuberculosis treatment including levofloxacin (LVFX) and to investigate the effectiveness of changing drug regimens at our hospital.
  
  
  METHODS
  A retrospective study was conducted on 331 patients with tuberculosis admitted to Tokyo National Hospital in 2005. Out of these 331 patients, LVFX was used in 48 (14.5%), 41 of which were initial-treatment cases. We studied why and how LVFX was used and compared bacteriological negative conversion rates between the initial-treatment cases in which the initial standard regimen was changed to regimens including LVFX, and those in which the initial standard regimen was either maintained throughout or modified with drugs other than LVFX. Sputum cultures were examined with Mycobacteria Growth Indicator Tube System (BACTEC MGIT 960).
  
  
  RESULTS
  LVFX was used in 41 (13.6%) of 302 initial-treatment cases and in 7 (24.1%) of 29 retreatment cases. Out of the 269 initial-treatment cases starting with the standard regimen, LVFX was later used in 26 cases (9.7%). The reasons for using LVFX were adverse reaction to antituberculosis drugs in 23 cases (88.5%) and resistance to antituberculosis drugs in 3 cases (11.5%). We investigated the bacteriological conversion rate in 228 patients who could be followed up for more than five months. The conversion rates in 105 cases under the standard regimen including PZA (PZA+) were 92.4% in three months, 98.1% in four months, and 100% in five months. The rates in 56 cases under the standard regimen without PZA (PZA-) were 92.9 %, 98.2% and 100%,respectively. The rates of 22 cases under the initial regimen modified with LVFX (LVFX +) were 68.2 %, 95.5% and 100%, respectively. In 45 cases under the initial regimen modified with drugs other than LVFX (LVFX-), the rates were 80.0%, 97.8% and 100%, respectively.
  
  
  CONCLUSIONS
  This study showed that LVFX was an effective drug in terms of the bacteriological conversion rate, without adverse reaction. LVFX is not approved as an antituberculosis drug in Japan, but it is often used in cases of MDR-TB or in situations in which the patients cannot continue treatment with the standard regimen. We hope that LVFX will be approved as an antituberculosis drug as soon as possible in Japan.
authors: National Hospital Organization Tokyo National Hospital, Japan. komanogi@juntendo.ac.jp
authors: Makiko
authors: M
authors: Kunogi
authors: Yoshiko
authors: Y
authors: Kawabe
authors: Junko
authors: J
authors: Suzuki
authors: Masahiro
authors: M
authors: Shimada
authors: Yugo
authors: Y
authors: Kaneko
authors: Yoshinori
authors: Y
authors: Matsui
authors: Masahiro
authors: M
authors: Kawashima
authors: Nobuharu
authors: N
authors: Ohshima
authors: Haruyuki
authors: H
authors: Ariga
authors: Kimihiko
authors: K
authors: Masuda
authors: Hironori
authors: H
authors: Matsui
authors: Atsuhisa
authors: A
authors: Tamura
authors: Hideaki
authors: H
authors: Nagai
authors: Shinobu
authors: S
authors: Akagawa
authors: Naohiro
authors: N
authors: Nagayama
authors: Emiko
authors: E
authors: Toyota
authors: Kazuko
authors: K
authors: Machida
authors: Yutsuki
authors: Y
authors: Nakajima
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000995:Antitubercular Agents / Q000009:adverse effects; D004334:Drug Administration Schedule; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D014376:Tuberculosis / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D064704:Levofloxacin; D015242:Ofloxacin