TY - JOUR
T1 - Community-acquired pneumonia and tuberculosis
T2 - differential diagnosis and the use of fluoroquinolones
AU - Grossman, R.F.
AU - Hsueh, P.-R.
AU - Gillespie, S.H.
AU - Blasi, F.
N1 - Funding: This article is based on the content of a presentation by R.F. Grossman entitled ‘‘Fluoroquinolones: a role in CAP and TB’’, part of the CME symposium entitled ‘‘Fluoroquinolones: CAP, TB and the importance of differential diagnosis’’ at the 15 th International Congress on Infectious Diseases (ICID), Bangkok, Thailand, June 13–16, 2012, which was sponsored by Bayer HealthCare (Germany).
PY - 2014/1/1
Y1 - 2014/1/1
N2 - The respiratory fluoroquinolones moxifloxacin, gemifloxacin, and high-dose levofloxacin are recommended in guidelines for effective empirical antimicrobial therapy of community-acquired pneumonia (CAP). The use of these antibiotics for this indication in areas with a high prevalence of tuberculosis (TB) has been questioned due to the perception that they contribute both to delays in the diagnosis of pulmonary TB and to the emergence of fluoroquinolone-resistant strains of Mycobacterium tuberculosis. In this review, we consider some of the important questions regarding the potential use of fluoroquinolones for the treatment of CAP where the burden of TB is high. The evidence suggests that the use of fluoroquinolones as recommended for 5-10 days as empirical treatment for CAP, according to current clinical management guidelines, is appropriate even in TB-endemic regions. It is critical to quickly exclude M. tuberculosis as a cause of CAP using the most rapid relevant diagnostic investigations in the management of all patients with CAP.
AB - The respiratory fluoroquinolones moxifloxacin, gemifloxacin, and high-dose levofloxacin are recommended in guidelines for effective empirical antimicrobial therapy of community-acquired pneumonia (CAP). The use of these antibiotics for this indication in areas with a high prevalence of tuberculosis (TB) has been questioned due to the perception that they contribute both to delays in the diagnosis of pulmonary TB and to the emergence of fluoroquinolone-resistant strains of Mycobacterium tuberculosis. In this review, we consider some of the important questions regarding the potential use of fluoroquinolones for the treatment of CAP where the burden of TB is high. The evidence suggests that the use of fluoroquinolones as recommended for 5-10 days as empirical treatment for CAP, according to current clinical management guidelines, is appropriate even in TB-endemic regions. It is critical to quickly exclude M. tuberculosis as a cause of CAP using the most rapid relevant diagnostic investigations in the management of all patients with CAP.
KW - Fluoroquinolone
KW - Tuberculosis
KW - Pneumonia
KW - Differential diagnosis
KW - Resistance
KW - Mycobacterium tuberculosis
UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-84891557923&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2013.09.013
DO - 10.1016/j.ijid.2013.09.013
M3 - Article
AN - SCOPUS:84891557923
SN - 1201-9712
VL - 18
SP - 14
EP - 21
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 1
ER -