Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study

Meng Rui Lee; Chih Hsin Lee; Jann Yuan Wang; Shih Wei Lee; Jen Chung Ko; Li Na Lee

doi:10.1016/j.jfma.2019.06.008

Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study

Meng Rui Lee, Chih Hsin Lee, Jann Yuan Wang, Shih Wei Lee, Jen Chung Ko, Li Na Lee

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Background/Purpose: Little remains known regarding whether newer FQ with less anti-mycobacterial activity (gemifloxacin) would reduce treatment delay. Methods: We identified one hospital-based cohort (HBC) and one population-based cohort (PBC) including patients receiving amoxicillin/clavulanate acid (Beta-lactam), gemifloxacin (Gemi), and fluoroquinolones other than gemifloxacin (Non-Gemi FQ) prior to TB treatment. Results: A total of 201 patients in the HBC and 3544 patients in the PBC were recruited. After 1:1 propensity score matching, TB treatment delay was statistically insignificant between Beta-lactam, Gemi group, and Non-Gemi FQ group in HBC (Beta-lactam vs Gemi: 22.3 ± 21.4 d vs 28.6 ± 27.9 d, p = 0.292; Beta-lactam vs Non-Gemi FQ: 33.3 ± 26.5 d vs 50.3 ± 47.3 d, p = 0.135) and PBC (Beta-lactam vs Gemi: 26.4 ± 29.1 vs 25.0 ± 28.1, p = 0.638; Beta-lactam vs Non-Gemi FQ: 29.4 ± 36.0 d vs 32.7 ± 35.0 d, p = 0.124, Non-Gemi FQ vs Gemi: 28.4 ± 33.0 d vs 25.0 ± 28.1 d, p = 0.29). Conclusion: While limited by relatively low case number, our study showed that use of gemifloxacin neither results in nor reduces delay in TB treatment. The issue of FQ use on TB treatment delay was also not observed in our study. Early survey and maintaining high clinical alertness remains the key to reducing TB treatment delay.

Original language	English
Pages (from-to)	367-376
Number of pages	10
Journal	Journal of the Formosan Medical Association
Volume	119
Issue number	1P2
DOIs	https://doi.org/10.1016/j.jfma.2019.06.008
Publication status	Published - Jan 2020

Keywords

Beta-lactam
Fluoroquinolone
Gemifloxacin
Treatment delay
Tuberculosis

ASJC Scopus subject areas

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jfma.2019.06.008

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Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study. / Lee, Meng Rui; Lee, Chih Hsin; Wang, Jann Yuan et al.
In: Journal of the Formosan Medical Association, Vol. 119, No. 1P2, 01.2020, p. 367-376.

Research output: Contribution to journal › Article › peer-review

@article{a14dc498597d43009c3faf4ea7fbcc40,

title = "Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study",

abstract = "Background/Purpose: Little remains known regarding whether newer FQ with less anti-mycobacterial activity (gemifloxacin) would reduce treatment delay. Methods: We identified one hospital-based cohort (HBC) and one population-based cohort (PBC) including patients receiving amoxicillin/clavulanate acid (Beta-lactam), gemifloxacin (Gemi), and fluoroquinolones other than gemifloxacin (Non-Gemi FQ) prior to TB treatment. Results: A total of 201 patients in the HBC and 3544 patients in the PBC were recruited. After 1:1 propensity score matching, TB treatment delay was statistically insignificant between Beta-lactam, Gemi group, and Non-Gemi FQ group in HBC (Beta-lactam vs Gemi: 22.3 ± 21.4 d vs 28.6 ± 27.9 d, p = 0.292; Beta-lactam vs Non-Gemi FQ: 33.3 ± 26.5 d vs 50.3 ± 47.3 d, p = 0.135) and PBC (Beta-lactam vs Gemi: 26.4 ± 29.1 vs 25.0 ± 28.1, p = 0.638; Beta-lactam vs Non-Gemi FQ: 29.4 ± 36.0 d vs 32.7 ± 35.0 d, p = 0.124, Non-Gemi FQ vs Gemi: 28.4 ± 33.0 d vs 25.0 ± 28.1 d, p = 0.29). Conclusion: While limited by relatively low case number, our study showed that use of gemifloxacin neither results in nor reduces delay in TB treatment. The issue of FQ use on TB treatment delay was also not observed in our study. Early survey and maintaining high clinical alertness remains the key to reducing TB treatment delay.",

keywords = "Beta-lactam, Fluoroquinolone, Gemifloxacin, Treatment delay, Tuberculosis",

author = "Lee, {Meng Rui} and Lee, {Chih Hsin} and Wang, {Jann Yuan} and Lee, {Shih Wei} and Ko, {Jen Chung} and Lee, {Li Na}",

note = "Funding Information: This study was funded by the Taiwan Ministry of Science and Technology ( NSC101-3114-Y-002-003 , MOST104-2321-B-002-058 ), the Ministry of Health and Welfare ( MOHW105-CDC-C-114-00103 ) and National Taiwan University Hospital Hsin-Chu Branch (108-HCH010). The funders had no role in the study design, data analysis, and manuscript writing. Funding Information: This study was funded by the Taiwan Ministry of Science and Technology (NSC101-3114-Y-002-003, MOST104-2321-B-002-058), the Ministry of Health and Welfare (MOHW105-CDC-C-114-00103) and National Taiwan University Hospital Hsin-Chu Branch (108-HCH010). The funders had no role in the study design, data analysis, and manuscript writing. Nil. Publisher Copyright: {\textcopyright} 2019 Formosan Medical Association",

year = "2020",

month = jan,

doi = "10.1016/j.jfma.2019.06.008",

language = "English",

volume = "119",

pages = "367--376",

journal = "Journal of the Formosan Medical Association",

issn = "0929-6646",

publisher = "Elsevier B.V.",

number = "1P2",

}

TY - JOUR

T1 - Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis

T2 - Hospital-based and population-based cohort study

AU - Lee, Meng Rui

AU - Lee, Chih Hsin

AU - Wang, Jann Yuan

AU - Lee, Shih Wei

AU - Ko, Jen Chung

AU - Lee, Li Na

N1 - Funding Information: This study was funded by the Taiwan Ministry of Science and Technology ( NSC101-3114-Y-002-003 , MOST104-2321-B-002-058 ), the Ministry of Health and Welfare ( MOHW105-CDC-C-114-00103 ) and National Taiwan University Hospital Hsin-Chu Branch (108-HCH010). The funders had no role in the study design, data analysis, and manuscript writing. Funding Information: This study was funded by the Taiwan Ministry of Science and Technology (NSC101-3114-Y-002-003, MOST104-2321-B-002-058), the Ministry of Health and Welfare (MOHW105-CDC-C-114-00103) and National Taiwan University Hospital Hsin-Chu Branch (108-HCH010). The funders had no role in the study design, data analysis, and manuscript writing. Nil. Publisher Copyright: © 2019 Formosan Medical Association

PY - 2020/1

Y1 - 2020/1

N2 - Background/Purpose: Little remains known regarding whether newer FQ with less anti-mycobacterial activity (gemifloxacin) would reduce treatment delay. Methods: We identified one hospital-based cohort (HBC) and one population-based cohort (PBC) including patients receiving amoxicillin/clavulanate acid (Beta-lactam), gemifloxacin (Gemi), and fluoroquinolones other than gemifloxacin (Non-Gemi FQ) prior to TB treatment. Results: A total of 201 patients in the HBC and 3544 patients in the PBC were recruited. After 1:1 propensity score matching, TB treatment delay was statistically insignificant between Beta-lactam, Gemi group, and Non-Gemi FQ group in HBC (Beta-lactam vs Gemi: 22.3 ± 21.4 d vs 28.6 ± 27.9 d, p = 0.292; Beta-lactam vs Non-Gemi FQ: 33.3 ± 26.5 d vs 50.3 ± 47.3 d, p = 0.135) and PBC (Beta-lactam vs Gemi: 26.4 ± 29.1 vs 25.0 ± 28.1, p = 0.638; Beta-lactam vs Non-Gemi FQ: 29.4 ± 36.0 d vs 32.7 ± 35.0 d, p = 0.124, Non-Gemi FQ vs Gemi: 28.4 ± 33.0 d vs 25.0 ± 28.1 d, p = 0.29). Conclusion: While limited by relatively low case number, our study showed that use of gemifloxacin neither results in nor reduces delay in TB treatment. The issue of FQ use on TB treatment delay was also not observed in our study. Early survey and maintaining high clinical alertness remains the key to reducing TB treatment delay.

AB - Background/Purpose: Little remains known regarding whether newer FQ with less anti-mycobacterial activity (gemifloxacin) would reduce treatment delay. Methods: We identified one hospital-based cohort (HBC) and one population-based cohort (PBC) including patients receiving amoxicillin/clavulanate acid (Beta-lactam), gemifloxacin (Gemi), and fluoroquinolones other than gemifloxacin (Non-Gemi FQ) prior to TB treatment. Results: A total of 201 patients in the HBC and 3544 patients in the PBC were recruited. After 1:1 propensity score matching, TB treatment delay was statistically insignificant between Beta-lactam, Gemi group, and Non-Gemi FQ group in HBC (Beta-lactam vs Gemi: 22.3 ± 21.4 d vs 28.6 ± 27.9 d, p = 0.292; Beta-lactam vs Non-Gemi FQ: 33.3 ± 26.5 d vs 50.3 ± 47.3 d, p = 0.135) and PBC (Beta-lactam vs Gemi: 26.4 ± 29.1 vs 25.0 ± 28.1, p = 0.638; Beta-lactam vs Non-Gemi FQ: 29.4 ± 36.0 d vs 32.7 ± 35.0 d, p = 0.124, Non-Gemi FQ vs Gemi: 28.4 ± 33.0 d vs 25.0 ± 28.1 d, p = 0.29). Conclusion: While limited by relatively low case number, our study showed that use of gemifloxacin neither results in nor reduces delay in TB treatment. The issue of FQ use on TB treatment delay was also not observed in our study. Early survey and maintaining high clinical alertness remains the key to reducing TB treatment delay.

KW - Beta-lactam

KW - Fluoroquinolone

KW - Gemifloxacin

KW - Treatment delay

KW - Tuberculosis

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U2 - 10.1016/j.jfma.2019.06.008

DO - 10.1016/j.jfma.2019.06.008

M3 - Article

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SN - 0929-6646

VL - 119

SP - 367

EP - 376

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

IS - 1P2

ER -

Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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