Abstract Background
Fluoroquinolones are the backbone of multidrug resistant
tuberculosis treatment regimens. Despite the high burden of multidrug resistant
tuberculosis in the country, little is known about
drug resistance patterns,
prevalence, and predictors of
fluoroquinolones resistance among multidrug resistant
tuberculosis patients from
Pakistan. Objective To evaluate
drug resistance patterns,
prevalence, and predictors of
fluoroquinolones resistance in multidrug resistant
tuberculosis patients.
Methods This was a
cross-sectional study conducted at a programmatic management unit of
drug resistant
tuberculosis, Lady
Reading Hospital Peshawar,
Pakistan. Two hundred and forty-three newly diagnosed multidrug resistant
tuberculosis patients consecutively enrolled for
treatment at study site from January 1, 2012 to July 28, 2013 were included in the study. A standardized
data collection form was used to collect
patients’ socio-demographic, microbiological, and clinical data. SPSS 16 was used for
data analysis. Results High degree of
drug resistance (median 5
drugs, range 2–8) was observed. High proportion of
patients was resistant to all five first-line
anti-tuberculosis drugs (62.6%), and more than half were resistant to second line
drugs (55.1%). The majority of the
patients were
ofloxacin resistant (52.7%). Upon
multivariate analysis previous
tuberculosis treatment at private (OR = 1.953, p = 0.034) and public private mix (OR = 2.824, p = 0.046) sectors were predictors of
ofloxacin resistance. Conclusion The high degree of
drug resistance observed, particularly to
fluoroquinolones, is alarming. We recommend the
adoption of more restrictive
policies to control non-
prescription sale of
fluoroquinolones, its rational use by
physicians, and
training doctors in both private and public–private mix sectors to prevent further increase in
fluoroquinolones resistant
Mycobacterium tuberculosis strains.