TB Manual

Some clinicians add or substitute a fluoroquinolone during the intensive phase in people with extensive disease, in an effort to improve treatment response or enhance sputum clearance.²⁰ This practice may result in more rapid sputum clearance but not does appear to improve end-of-treatment outcomes and may be associated with a higher rate of adverse events.^19,20 In addition, high-dose, RMP-based regimens are often used in people with extensive or disseminated TB disease. There is no evidence to support improved long-term clinical outcomes with this strategy.³³

Recommendation

• We conditionally recommend against routine treatment intensification with fluoroquinolones or high-dose rifampin in people with extensive or disseminated TB (poor evidence).

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