Abstract 230 - IMPIEGO DEI GLICOPEPTIDI NELLA ... - SIMIT

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10° CONGRESSO NAZIONALE SIMIT
Abstract 211
- PYRAZINAMIDE AND LEVOFLOXACIN CHEMOPTOPHYLAXIS FOR LATENT
MULTIDRUG-RESISTANT TUBERCULOSIS: TOLERANCE AND KINETICS OF THE
QUANTIFERON -TB GOLD IN-TUBE TEST -
Bedini A.* [1] , Meacci M. [1] , Richeldi L. [1] , Mussini C. [1] , Garlassi E. [1] , Codeluppi M. [1] , Guaraldi G. [1] , Esposito
R. [1]
- [1] Policlinio di Modena ~ Modena
TUBERCOLOSI
Premessa: The treatment reccomanded for latent tuberculosis infection (LTBI) in contacts
exposed to mulridrug-resistant tuberculosis (MDR-TB) is pyrazinamide (PZA) combined
with either ethambutol (EMB) or a floroquinolone.
Obiettivo: The aim of the study was to evaluate the tolerance and the impact on the
Quantiferon TB values of the combined PZA and levofloxacin (LVX) treatment given for
LTBI, in 39 contacts previously exposed to a patient with active pulmonary MDR-TB
(resistance to RIF and INI, and reduced susceptibility to EMB) in a Italian prison. All the
contacts were tested with tubercolin skin test (TST) and Quantiferon TB Gold (QTB): in the
case of positivity, the patients were considered for a 6-months treatment with PZA and
LVX. Treatment was discontinued if increase in ALAT or ASAT was greater than four times
the upper limit of normal, or if the patient presented drug-related adverse effects.
Risultati: Among the 39 contacts with the index case, 17 (43.5%) resulted positive to both
TST and QTB, but only 13 (76.4%) accepted to receive chemoprophylaxis with PZA (20–
25 mg/kg/day) and LVX (500 mg/day). Only 5 (38,4%) patients termined the 6 months of
treatment, and the mean period of treatment was 108 days. The major reason for
discontinuation was asintomatic hepatitis (38,4%), followed by gastritis (15,3%), and
dyarrhoea (15,3%). The QTB value decrese in all the patients, independently to the
duration of the antimicrobial prophylaxis.The QTB never returned negative.
Conclusione: Although the small number of patients, the present study confirmed that
PZA and LVX prophylaxis is a poor tolerated option for MDR-latent TBC. The high
incidence of asintomatic hepatitis, gastritis and dyarroea reduced the number of patients
that concluded the 6 months of treatment. Although this, the kinetics of QTB seemed to
evidence a certain efficacy of the PZA and LVX, reducing the values in the 100% of the
patients that concluded the 6 months of prophylaxis. Larger studies are needed to
confirmed these impressions.