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Fluoroquinolones: a new treatment for tuberculosis?
1Department of Medical Microbiology, Royal Free Hospital School of Medicine, London, UK. stepheng@rfhsm.ac.uk
Summary
Fluoroquinolones show promise for treating tuberculosis, especially multidrug-resistant strains. However, more clinical data is needed before they can be used as a first-line treatment in all patients.
Area of Science:
- Pharmacology
- Infectious Diseases
- Microbiology
Background:
- Fluoroquinolones are effective antibiotics for bacterial infections, well-absorbed orally, and concentrated in respiratory tissues and macrophages.
- No new antituberculosis agents have emerged since rifampicin, creating a need for novel treatments.
- Fluoroquinolones exhibit in vitro activity against Mycobacterium tuberculosis at achievable concentrations.
Purpose of the Study:
- To investigate the potential efficacy of fluoroquinolones in the treatment of tuberculosis.
- To evaluate the safety and tolerability of fluoroquinolones in long-term therapy for bacterial infections.
Main Methods:
- In vitro studies assessing activity against Mycobacterium tuberculosis.
- In vivo treatment studies in mice.
- Limited clinical studies in humans, including evaluation of ciprofloxacin's early bactericidal activity.
Main Results:
- Fluoroquinolones demonstrated in vitro activity against Mycobacterium tuberculosis.
- Treatment studies in mice showed efficacy.
- Ciprofloxacin exhibited significant early bactericidal activity in human studies.
- Regimens with fluoroquinolones were comparable to standard treatments, except in HIV-seropositive patients where outcomes were poorer.
Conclusions:
- Fluoroquinolones show potential for tuberculosis treatment, particularly for multidrug-resistant tuberculosis or in patients with adverse reactions to other drugs.
- Insufficient clinical data currently prevents their use as a first-line tuberculosis treatment.
- Further clinical research is required to establish their role in tuberculosis management.