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COMMENTS AND OPINIONS
Fluoroquinolone Use With No Increase in Culture-Negative Tuberculosis—Reply
Timothy R. Sterling, MD
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In reply
We appreciate the interest of Matsushima et al in our article.1 The 12-month period before TB diagnosis during which we characterized fluoroquinolone exposure was arbitrarily chosen because the optimal time frame in which to characterize such exposure is unknown. Fluoroquinolone exposure can delay the diagnosis of TB.2 When fluoroquinolones are prescribed for infections thought by clinicians not to be TB, mycobacterial cultures are not obtained. A diagnosis of TB cannot be established unless it is considered. Thus, fluoroquinolone exposure months before TB diagnosis could be important. In addition, although we assessed for fluoroquinolone exposure in the 12 months before TB diagnosis, the median time between first fluoroquinolone exposure and TB diagnosis was much closer: 80 days. We have performed additional analyses to address the concerns of Matsushima et al, however. Of the 136 patients who received a fluoroquinolone, the proportions receiving their first course . . . [Full Text of this Article]
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RELATED LETTER
Fluoroquinolone Use With No Increase in Culture-Negative Tuberculosis
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Arch Intern Med. 2008;168(16):1824-1825.
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