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A new study shows that
misuse of a popular antibiotic is creating drug-resistant strains of
tuberculosis, or TB, a bacterial respiratory disease that the World Health
Organization says kills two million people worldwide each year.
Although TB is curable, treatment requires at least six months of continuous
therapy using several drugs at once. Researchers have been hopeful that a class
of antibiotic drugs called fluoroquinolones [pron. floor-oh-KWIN-oh-loans]
could help change that. But Rose Devasia [deh-VAHZ-ee-ah], an infectious
disease researcher at Vanderbilt University, says the effectiveness of these
safe, easy-to-take drugs has led to widespread overprescribing for a wide range
of illnesses, sometimes even before it's known what kind of infection is being
treated. That, says Devasia, can cause problems when patients actually have
tuberculosis when patients go to an emergency room and they have a cough. The
physician thinks, Oh, it's probably pneumonia. I'm going to give him a
fluoroquinolone. The fluoroquinolone partially [treats] the TB. He feels good
for about 10, 12, 13 days, but then the cough comes back. So he goes to another
physician or he goes back to another emergency room. He says, I've got this
cough. He gets another course of fluoroquinolones.
Devasia says each time a patient with undiagnosed tuberculosis is treated for
the wrong disease using fluoroquinolones, it increases the risk that he'll
develop fluoroquinolone-resistant TB.
In a new study published in the American Journal of Respiratory and Critical
Care Medicine, Devasia and her colleagues found that nearly one in five
tuberculosis patients had received fluoroquinolones in the year before they
were diagnosed with TB. A typical course of fluoroquinolones is about 10 days.
For every additional 10 days a patient took the medications, the odds of
developing fluoroquinolone-resistant TB increased by 50 percent.
In many developing-world pharmacies, fluoroquinolones are easily available
without a prescription, under names such as Cipro and Levaquin, and they're
used to treat everything from diarrhea to pneumonia.