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Newer Fluoroquinolones for the Treatment of Tuberculosis

Wing Wai Yew, MBBS, FRCP
The Hong Kong Tuberculosis, Chest and Heart Diseases Association, Hong Kong, China

The newer fluoroquinolones – levofloxacin, moxifloxacin and gatifloxacin – have potent bactericidal and sterilizing activities against Mycobacterium tuberculosis. Thus, they have the potential value in managing both drug-susceptible tuberculosis and drug-resistant tuberculosis, including the possibility of shortening the duration of treatment. The emergence of more "difficult" drug-resistance scenarios – fluoroquinolone-resistant multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis, pose a challenge to the global control of tuberculosis. The newer fluoroquinolones might also have clinical efficacy in some of the patients with such forms of the disease, perhaps reflecting partial bacillary cross-resistance only among the fluoroquinolones, and/or different optimal critical concentration cut-offs to define bacillary resistance to different fluoroquinolones. In summary, more experience is needed regarding the utility of newer fluoroquinolones for the treatment of tuberculosis.

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