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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
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, 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.
Devasia says the results of her study make her hesitant to support using
fluoroquinolones as the first choice against TB. She prefers to save them for
cases when the usual first-line drugs fail.