Anti-Bacterial Agents ; adverse effects ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Immunologic Factors ; therapeutic use ; Levofloxacin ; Ofloxacin ; adverse effects ; Stevens-Johnson Syndrome ; drug therapy ; etiology

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; administration & dosage ; Enterobacter cloacae ; Enterobacteriaceae Infections ; drug therapy ; Female ; Gentamicins ; adverse effects ; Humans ; Imipenem ; adverse effects ; Isosorbide Dinitrate ; adverse effects ; analogs & derivatives ; Male ; Ofloxacin ; adverse effects ; Software

Fluoroquinolones (FQs) represent a major class of antimicrobials that have a high potential as therapeutic agents. Although FQs are generally safe for the use as antimicrobials, they may induce tendinopathic complications such as tendinitis and tendon rupture. A number of factors have been suggested to further predispose a patient to such injuries. Hitherto, a few published cases on tendon disorders have implicated levofloxacin, a more recently introduced FQ. Here, we report a patient with levofloxacin-induced Achilles tendinitis, who exhibited no known predisposing factors. A 20-year-old man without any history of disease or medication presented with community-acquired pneumonia. Levofloxacin was administered and 3 days later, he complained of pain in the left Achilles tendon and revealed redness and swelling in the area. On suspecting Achilles tendinitis, levofloxacin treatment was discontinued, and the tendinitis subsequently improved. To our knowledge, this is the first case report on FQ-induced Achilles tendinitis in Korea.
Achilles Tendon/*drug effects/pathology ; Adult ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Community-Acquired Infections/drug therapy ; Disease Susceptibility ; Humans ; Male ; Ofloxacin/*adverse effects/therapeutic use ; Pneumonia/drug therapy ; Tendinopathy/*chemically induced ; Young Adult

BACKGROUND/AIMS: To compare the effect of levofloxacin and moxifloxacin on treatment outcomes among patients with multidrug-resistant tuberculosis (MDR-TB). METHODS: A retrospective analysis of 171 patients with MDR-TB receiving either levofloxacin or moxifloxacin was performed. Treatment responses were categorized into treatment success (cured and treatment completed) or adverse treatment outcome (death, failure, and relapsed). RESULTS: The median age of the patients was 42.0 years. Approximately 56% of the patients were male. Seventeen patients had extensively drug-resistant tuberculosis, and 20 had a surgical resection. A total of 123 patients (71.9%) received levofloxacin for a median 594 days, and 48 patients (28.1%) received moxifloxacin for a median 673 days. Other baseline demographic, clinical, and radiographic characteristics were similar between the two groups. The moxifloxacin group had a significantly higher number of resistant drugs (p < 0.001) and a higher incidence of resistance to ofloxacin (p = 0.005) in the drug sensitivity test. The treatment success rate was 78.9% in the levofloxacin group and 83.3% in the moxifloxacin group (p = 0.42). Adverse reactions occurred at similar rates in the groups (p = 0.44). Patients in the moxifloxacin group were not more likely to have treatment success than those in the levofloxacin group (adjusted odds ratio, 0.76; 95% confidence interval, 0.24 to 2.43; p = 0.65). CONCLUSIONS: Both levofloxacin and moxifloxacin showed equivalent efficacy for treating MDR-TB.
Adult ; Antitubercular Agents/adverse effects/*therapeutic use ; Aza Compounds/adverse effects/*therapeutic use ; Case-Control Studies ; Chi-Square Distribution ; *Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Extensively Drug-Resistant Tuberculosis/*drug therapy/microbiology/mortality ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Mycobacterium tuberculosis/*drug effects/pathogenicity ; Odds Ratio ; Ofloxacin/adverse effects/*therapeutic use ; Quinolines/adverse effects/*therapeutic use ; Recurrence ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Tuberculosis, Multidrug-Resistant/*drug therapy/microbiology/mortality