Fluoroquinolones for treating tuberculosis (presumed drug-sensitive)

Added August 13, 2019

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Substituting or adding fluoroquinolones to established firstline antituberculous drug regimens gives no additional benefit or risks.

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis bacteria. Over two billion people worldwide are believed to be latently infected with TB and approximately 10% of these people will develop active TB later in life. The World Health Organization recommends fluoroquinolones for people with presumed drug-sensitive tuberculosis who cannot take standard first-line drugs. Their use could shorten the length of treatment and improve other outcomes in this population. This review includes research published up to 6 March 2013 and identifies five randomised controlled trials (1330 people) that met the inclusion criteria. No studies examined the effect of including fluoroquinolones in a standard six month TB treatment regimen on treatment failure. It is unknown whether adding fluoroquinolones or substituting fluoroquinolones for ethambutol in a standard six month TB treatment regimen reduces treatment failure, relapse, death, or adverse events. HIV‐positive participants were relatively well‐represented in the included trials but none of the included trials stratified outcomes by HIV status. Also, the primary outcomes of all the included trials were reached before initiation of antiretroviral treatment. Currently, there are nine randomised controlled trials ongoing.