Increased resistance to ciprofloxacin and ofloxacin in multidrug-resistantMycobacterium tuberculosis isolates from patients seen at a tertiary hospital in the Philippines

SETTING: A hospital-based study at the Makati Medical Center, Makati City, Philippines, a hyperendemic area for tuberculosis (TB). OBJECTIVE: TO determine the susceptibility of Mycobacterium tuberculosis to ciprofloxacin and ofloxacin. DESIGN: Retrospective analysis of drug susceptibility tests (DST) of M. tub erculosis isolated from 1995-2000. RESULTS: Resistance to ciprofloxacin was 26.8%, ofloxacin 35.3%, and multid rug resistance (MDR) was 17.2%. Of the MDR strains, 51.4% were resistant to ciprofloxacin and ofloxacin. Acquired resistance was significantly higher for all first-line drugs and for ciprofloxacin, but not for ofloxacin. A si gnificant increase in resistance to ciprofloxacin and ofloxacin was noted c ompared to 1989-1994, while resistance to the first-line drugs was not sign ificantly different. CONCLUSION: Ciprofloxacin and ofloxacin are now a significantly less effect ive alternative therapy in tuberculosis, particularly MDR-TB, due to a sele ction pressure from their widespread use in the treatment of TB and possibl y other infections in the community, which is hyperendemic for tuberculosis .