J Korean Med Sci.  2013 Mar;28(3):378-382. 10.3346/jkms.2013.28.3.378.

Clinical Effects of Gemifloxacin on the Delay of Tuberculosis Treatment

Affiliations
  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. kimdkmd@snu.ac.kr
  • 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
  • 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

Although gemifloxacin has low in vitro activity against Mycobacterium tuberculosis, the effect of gemifloxacin on the delay of tuberculosis (TB) treatment has not been validated in a clinical setting. The study group included patients with culture-confirmed pulmonary TB who initially received gemifloxacin for suspected community-acquired pneumonia (CAP). Two control groups contained patients treated with other fluoroquinolones or nonfluoroquinolone antibiotics. Sixteen cases were treated with gemifloxacin for suspected CAP before TB diagnosis. Sixteen and 32 patients were treated with other fluoroquinolones and nonfluoroquinolones, respectively. The median period from the initiation of antibiotics to the administration of anti-TB medication was nine days in the gemifloxacin group, which was significantly different from the other fluoroquinolones group (35 days). The median times for the nonfluoroquinolone group and the gemifloxacin group were not significantly different. There were no significant differences between the gemifloxacin and other fluoroquinolone group in terms of symptomatic and radiographic improvements. However, the frequency of radiographic improvement in the other fluoroquinolones group tended to be higher than in the gemifloxacin group. Gemifloxacin might be the preferred fluoroquinolone for treating CAP, to alleviate any concerns about delaying TB treatment.

Keyword

Fluoroquinolones; Tuberculosis; Pneumonia

MeSH Terms

Adult
Aged
Anti-Bacterial Agents/*therapeutic use
Case-Control Studies
Fluoroquinolones/*therapeutic use
Humans
Middle Aged
Naphthyridines/*therapeutic use
Pneumonia/complications/diagnosis
Tuberculosis/complications/*drug therapy/radiography
Anti-Bacterial Agents
Fluoroquinolones
Naphthyridines
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