The effects of ciprofloxacin on chest radiographic regression in patients with drug intolerance or resistant tuberculosis

Background: The aim of this study was to identify the clinical efficacy of ciprofloxacin as a second-line anti-tuberculosis agent in pulmonary tuberculosis patients with drug intolerance or resistance. Methods: There were 20 patients with drug related adverse effects or drug resistance enrolled in the ciprofloxacin treatment group (CG). There were also 32 patients enrolled in the non-ciprofloxacin treatment group (NCG) that maintained conventional drug regimens or the addition of other drugs like streptomycin. The radiographic presentation was evaluated using score grading. The speed and outcome of regression in the chest radiographic presentations were also evaluated. Results: Data showed the CG had significantly more rapid regression than the NCG in drug-resistant patients (p <0.01). For the adversely effected patients in the CG, the mean scores of pre- and post-treatment were 3.1 ± 0.2 and 2.2 ± 0.3 (p <0.001), respectively. For the adversely effected patients in the NCG, the mean score of pre-treatment was 3.7 ± 0.4 and post-treatment mean score was 3.0 ± 0.4 (p <0.05). For the drug-resistant patients in the CG, the mean scores of pre- and post-treatment were 4.3 ± 0.4 and 3.4 ± 0.5 (p <0.05), respectively. For the drug-resistant patients in the NCG, the mean score of pre-treatment was 3.7 ± 0.3 and post-treatment mean score was 3.2 ± 0.3 (no significant difference). Obviously, the CG had the same effects compared with the NCG in adverse-effect group. On the other hand, the CG had the tendency of more rapid radiographic regression and better radiographic outcomes than the NCG in drug-resistant patients. Conclusions: Ciprofloxacin provides a better option for second-line drug treatment for pulmonary tuberculosis when patients cannot use conventional anti-tuberculosis agents.