Previous use of quinolones: a surrogate marker for first line anti-tuberculosis drugs resistance in HIV-infected patients?

objectives: drug resistant mycobacterium tuberculosis causes much higher rates of treatment toxicity, failure or relapse, and mortality. we determined the drug resistant profile of mycobacterium tuberculosis strains isolated from a population of hiv-infected patients in southern brazil and studied the potential factors associated with resistance. methods: we conducted a retrospective cohort study to determine the resistance profile of mycobacterium tuberculosis isolated from hiv-infected patients and factors that could be associated with resistance from 2000 to 2005. results: 236 patients were included in the study. resistance to at least one drug was observed in 32 (14.6%) isolates, and multi-drug resistance was observed in 4 (1.82%) isolates. on multivariate analysis, previous use of tuberculostatics and quinolones were related to any first-line drug resistance. conclusions: in our study, previous quinolone use was significantly associated to first-line anti-tb drugs resistance. multi-drug-resistant tuberculosis (mdr-tb) is a major problem worldwide, and we believe quinolones should be used with caution in settings where tb is endemic.