Abstract

FLUROQUINOLONE EXPOSURE; A RISK FACTOR MULTI DRUG RESISTANT TUBERCULOSIS

Shethal Joju* and Alsa Ann George

ABSTRACT

Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a major public health issue in most of developing countries, despite scaling up interventions to achieve global control. Emergence of multi drug resistant TB (MDR-TB: organism resistant to isoniazid [INH] and rifampicin [RMP]) is a major hurdle for TB control programs especially in developing countries like India. The global report on drug resistance surveillance by the World Health Organization (WHO) estimated that 3.6% of new smear positive TB (NSP) cases and 20% of previously treated cases (PT) have MDR-TB. Fluoroquinolones (FQs) are a group of antibiotic that have tremendous activity against Mycobacterium tuberculosis (Mtb). They are bactericidal and enjoy a distinct status among second-line anti-tuberculosis (ATT) drugs due to their high oral bioavailability, good tolerability and low-to-moderate cost. In the last two decades, FQ mono-resistant strains of Mtb have emerged globally and the incidence have been increasing day by day. Resistance to second-line anti-TB drugs is a cause of grave concern for the community and tuberculosis control programmes. Mostly the patients with poor treatment outcomes are closely linked with presence of FQ resistance, this further complicates the case eventually leading to development of Extensively Drug-Resistant TB (XDR-TB).

Keywords: MDR TB, Fluroquinolone Resistance, XDR TB, Drug Resistant Tuberculosis.