Khongyot Thanawat, Laopaiboonkun Sawitree, Kawpradid Throngpon, Jitkamrop Kannuwat, Chanphakphoom Tawee, Uitrakul Suriyon
Department of Pharmaceutical Care, School of Pharmacy, Walailak University, Tha Sala 80160, Nakhon Si Thammarat, Thailand.
School of Tropical Medicine and Global Health, Nagasaki University, Sakamoto, Nagasaki 852-8523, Japan.
Adv Pharmacol Pharm Sci. 2022 Jun 3;2022:5647071. doi: 10.1155/2022/5647071. eCollection 2022.
Levofloxacin is one of the broad-spectrum antibiotics that is indicated for the second-line treatment of tuberculosis (TB). However, using levofloxacin as an empirical therapy for patients without confirmation of TB could still be observed. This descriptive retrospective study, therefore, aimed to investigate the number of levofloxacin use in patients suspected TB in a community hospital in Thailand.
Patient medical charts of all patients who were admitted to a community hospital in Nakhon Si Thammarat, Thailand, from 2016 to 2017, were reviewed. Patients who were suspected TB and received any levofloxacin-containing regimens were included. Data on patient characteristics and the received regimens were descriptively analyzed and reported as percentage and frequency.
There were a total of 21 patients who received levofloxacin in the hospital. Six of them (28.57%) had the diagnosis of hepatitis. The most prescribed regimen as empirical therapy was levofloxacin, ethambutol, and amikacin (66.67%). After the confirmation of TB using acid-fast bacilli (AFB) test, ten patients (47.62%) still received levofloxacin-containing regimens.
The results from this study indicated high usage of levofloxacin despite no evidence of drug-resistant TB or negative AFB results in a community hospital in Thailand. The results from this study will be further used for the investigation of the prevalence of antibiotic resistance and clinical outcomes of using second-line regimens for TB treatment.
左氧氟沙星是用于结核病（TB）二线治疗的广谱抗生素之一。然而，在未确诊结核病的患者中仍可观察到将左氧氟沙星用作经验性治疗的情况。因此，这项描述性回顾性研究旨在调查泰国一家社区医院疑似结核病患者中左氧氟沙星的使用数量。
回顾了2016年至2017年期间入住泰国那空是贪玛叻府一家社区医院的所有患者的病历。纳入疑似结核病并接受任何含左氧氟沙星治疗方案的患者。对患者特征和所接受治疗方案的数据进行描述性分析，并以百分比和频率报告。
该医院共有21名患者接受了左氧氟沙星治疗。其中6名（28.57%）被诊断为肝炎。作为经验性治疗最常用的方案是左氧氟沙星、乙胺丁醇和阿米卡星（66.67%）。在使用抗酸杆菌（AFB）检测确诊结核病后，仍有10名患者（47.62%）接受含左氧氟沙星的治疗方案。
这项研究的结果表明，在泰国一家社区医院，尽管没有耐多药结核病证据或AFB检测结果为阴性，但左氧氟沙星的使用量仍然很高。这项研究的结果将进一步用于调查抗生素耐药性的流行情况以及使用二线治疗方案治疗结核病的临床结果。
