Therapeutic drug monitoring to prevent acquired drug resistance of fluoroquinolones in the treatment of tuberculosis

The new short-course World Health Organization (WHO)-endorsed regimen for multidrug-resistant (MDR) tuberculosis (TB) resistant to rifampicin and isoniazid gives hope for patients and care-givers. However, there is still an unacceptable proportion of treatment failure and evidence of man-made acquired drug resistance of fluoroquinolones during programmatic treatment of MDR-TB [1]. The appropriate use of fluoroquinolones is crucial in MDR-TB treatment, perhaps even more so in the new WHO-endorsed short-course MDR-TB regimen. Current shortcomings with inappropriate use of fluoroquinolones, such as underdosing, need to be avoided in order to prevent failure of the new short-course regimen. Therapeutic drug monitoring of fluoroquinolones might prevent acquired XDR-TB