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
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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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