Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015

Objective/background: Fluoroquinolones (FQs) are important anti-tuberculous drugs for the treatment of multidrug-resistant (MDR) tuberculosis. Resistance to FQs leads to fewer options for treatment of tuberculosis (TB), and infection with such strains may also require longer treatment duration. Tren...

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Main Authors: S Shakoor, S Tahseen, K Jabeen, R Fatima, F R Malik, A H Rizvi, R Hasan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:International Journal of Mycobacteriology
Subjects:
Online Access:http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=4;spage=412;epage=416;aulast=Shakoor
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author S Shakoor
S Tahseen
K Jabeen
R Fatima
F R Malik
A H Rizvi
R Hasan
author_facet S Shakoor
S Tahseen
K Jabeen
R Fatima
F R Malik
A H Rizvi
R Hasan
author_sort S Shakoor
collection DOAJ
description Objective/background: Fluoroquinolones (FQs) are important anti-tuberculous drugs for the treatment of multidrug-resistant (MDR) tuberculosis. Resistance to FQs leads to fewer options for treatment of tuberculosis (TB), and infection with such strains may also require longer treatment duration. Trends of resistance in Mycobacterium tuberculosis (MTB) are indicators of MTB-resistance evolution. Drivers of such resistance need to be understood and studied to inform preventive strategies. Methods: Here, we present FQ-resistance rates and trends in Pakistan from 2010 to 2015 and compare rates with FQ-consumption data and rates in other community pathogens. Results: Our results reveal a recent decrease in FQ-resistance rates in MTB, but an increase in resistance for Haemophilus influenzae and Shigella spp. Correlation of FQ resistance with FQ consumption at the population level was weak for MTB, although strong associations were noted for H. influenzae and Shigella spp. Conclusion: We discuss the possible reasons for the decrease in resistance rates in TB, putative drivers of resistance other than volume of FQ consumption, and the possible impact of the National Tuberculosis Programme and drug regulatory activities.
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spelling doaj.art-1bb26990675a439ca446cdd6faecfce12022-12-21T17:57:20ZengWolters Kluwer Medknow PublicationsInternational Journal of Mycobacteriology2212-55312212-554X2016-01-015441241610.1016/j.ijmyco.2016.07.008Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015S ShakoorS TahseenK JabeenR FatimaF R MalikA H RizviR HasanObjective/background: Fluoroquinolones (FQs) are important anti-tuberculous drugs for the treatment of multidrug-resistant (MDR) tuberculosis. Resistance to FQs leads to fewer options for treatment of tuberculosis (TB), and infection with such strains may also require longer treatment duration. Trends of resistance in Mycobacterium tuberculosis (MTB) are indicators of MTB-resistance evolution. Drivers of such resistance need to be understood and studied to inform preventive strategies. Methods: Here, we present FQ-resistance rates and trends in Pakistan from 2010 to 2015 and compare rates with FQ-consumption data and rates in other community pathogens. Results: Our results reveal a recent decrease in FQ-resistance rates in MTB, but an increase in resistance for Haemophilus influenzae and Shigella spp. Correlation of FQ resistance with FQ consumption at the population level was weak for MTB, although strong associations were noted for H. influenzae and Shigella spp. Conclusion: We discuss the possible reasons for the decrease in resistance rates in TB, putative drivers of resistance other than volume of FQ consumption, and the possible impact of the National Tuberculosis Programme and drug regulatory activities.http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=4;spage=412;epage=416;aulast=ShakoorConsumptionDefined daily doseFluoroquinoloneResistanceSelective pressureTuberculosis
spellingShingle S Shakoor
S Tahseen
K Jabeen
R Fatima
F R Malik
A H Rizvi
R Hasan
Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
International Journal of Mycobacteriology
Consumption
Defined daily dose
Fluoroquinolone
Resistance
Selective pressure
Tuberculosis
title Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
title_full Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
title_fullStr Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
title_full_unstemmed Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
title_short Fluoroquinolone consumption and -resistance trends in Mycobacterium tuberculosis and other respiratory pathogens: Ecological antibiotic pressure and consequences in Pakistan, 2009–2015
title_sort fluoroquinolone consumption and resistance trends in mycobacterium tuberculosis and other respiratory pathogens ecological antibiotic pressure and consequences in pakistan 2009 2015
topic Consumption
Defined daily dose
Fluoroquinolone
Resistance
Selective pressure
Tuberculosis
url http://www.ijmyco.org/article.asp?issn=2212-5531;year=2016;volume=5;issue=4;spage=412;epage=416;aulast=Shakoor
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