Empirical treatment of community-acquired pneumonia and the development of fluoroquinolone-resistant tuberculosis

Abstract

Background. Fluoroquinolone (FLQ) antibiotics are not uncommonly prescribed for community-acquired pneumonia that is later proven to be pulmonary tuberculosis (TB). Such FLQ monotherapy may result in FLQ- resistant pulmonary TB. Methods. To assess outpatient FLQ use by patients with culture-proven pulmonary TB before diagnosis, TB registries in Alberta and Saskatchewan, Canada, were linked with provincial and federal drug benefit plans. To assess FLQ resistance, a case-control study was performed. Results. Of 428 patients with pulmonary TB who were covered by a drug benefit plan, 74 (17.3%) had received 3=1 FLQ prescription during the 6 months immediately before receipt of the diagnosis. Older patients (age, >64 years) were more likely than younger patients (age, 15-64 years) to be prescribed an FLQ (P