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TITLE:

ADDITION OF LEVOFLOXACIN AND AMIKACIN IS RELATED WITH ADVANCED CULTURE CONVERSION RATE IN PULMONARY TUBERCULOSIS

AUTHORS:

Dr Noman Yousaf, Dr Muhammad Arslan Iqbal, Dr Kainat Akhtar

ABSTRACT:

Aim: To study that addition of Amikacin and Levofloxacin to the standard anti-tuberculosis regimen is associated with higher culture conversion rate at 02 months. Study design: Randomized controlled trial Place and duration of studies: In the Medicine Unit-II of Bahawal Victoria Hospital, Bahawalpur for one-year duration from May 2019 to May 2020. Materials and methods: One hundred tuberculosis patients with a positive sputum culture result were selected by a method unusual for the probability of sampling. The patients were divided into two groups using the randomization method. Group 1 received HREZ (INH, rifampicin and ethambutol and PZA) and group 2 received two additional medications ie levofloxacin orally daily and Amikacin IV injection daily. The sputum culture was repeated at the end of the 02-month treatment, and the percent culture conversion in each group was determined. Data was collected using a carefully designed, structured data collection template and analyzed using SPSS version 18. The frequencies and percentages of various variables were calculated. The comparison of the means was made using the Student's t-test and the frequencies and percentages were compared using the chi-square test and the Fisher's exact test. A p value of <0.05 was considered significant. Results: The mean age was 48.46 ± 17.76 and 50.82 ± 17.59 (p = 0.506) in Groups 1 and 2, respectively. Group 1 consisted of 31 (62%) men and 19 (38%) women, while when Group 2 included 40 (80%) men and 10 (20%) women (P = 0.077). In group 1 (on standard ATT) 42 (84%) were culture negative, and in group 2 (standard ATT plus levofloxacin and amikacin) 49 (98%) were culture negative at two months (P = 0.0309)). Conclusion: The addition of amikacin and levofloxacin to the standard ATT regimen is associated with a higher culture conversion rate after 2 months. The regimen containing amikacin and levofloxacin was not associated with any side effects and was well tolerated by patients. Key words: pulmonary tuberculosis, culture conversion, amikacin, levofloxacin.

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