• Masood Satti
  • Farah Faqir
  • Abdul Sattar
  • Shahid Abbasi
  • Tariq Butt
  • Karamat Ahmed Karamat
  • Mubashir Abidi


Background: Tuberculosis was a leading cause of death at the turn of the 20th century and continues tobe one of the medical scourges of mankind. Before the availability of antimicrobial drugs thecornerstone of treatment was rest in the open air in sanatoria. The major breakthrough in treatment oftuberculosis came with the discovery of Streptomycin. Later, INH, Ethambutol, Pyrazinamide,Rifampicin were added to the arsenal. Objective of this study was to determine the sensitivity of clinicalisolates of Mycobacterium tuberculosis against two second-line anti-tuberculosis drugs, Amikacin andCiprofloxacin. Methods: This cross-sectional study was conducted at Department of Microbiology,Armed Forces Institute of Pathology (AFIP) Rawalpindi. All routine clinical samples received for acidfast bacilli (AFB) in the Department of Microbiology, AFIP, Rawalpindi were processed by modifiedPetroff’s technique and inoculated on Lowenstein Jensen (LJ) medium and Bactec 460 Mycobacteriumtuberculosis culture system. After identification of M. tuberculosis sensitivity was performed againstfirst-line anti-tuberculosis drugs. Then susceptibility of M. tuberculosis isolates against Amikacin andCiprofloxacin was performed on LJ medium. H37Rv was used as control strain. Results: Results wereinterpreted using resistance ratio method. Out of 100 M. tuberculosis isolates, 98% were sensitive toAmikacin and 97% to Ciprofloxacin. Conclusion: Amikacin and Ciprofloxacin are very effective 2ndline anti-tuberculosis drugs against tuberculosis isolates in our set-up.Keywords: Tuberculosis, MDR-tuberculosis, susceptibility, second-line anti-tuberculosis drugs


Kochi A. The global tuberculosis situation and the newer

control strategy of the world health organization. Tubercle

;72:1–6. Reproduced: Bull World Health Organization


Haas DW, Prez RMD. Mycobacterial Diseases. In: Mandell

GL, Benett JE, Dolin R. (eds). Mandell Douglas and Benett’s

Principle and Practice of infectious diseases, 6th ed. New

York: Churchill Livingstone;2005.p.2213–43.

Salfinger. HM, Hale YM, Driscoll JR. Diagnostic tools in

tuberculosis. Respiration 1998;65:63–170.

Doren GV. Diagnostic mycobacteriology; where are we

today? J Clin Microbiol 1996;34:1873–6.

Boehme CC, Nabeta P, Hillemann D, Nicol MP, Shenai S,

Krapp F, et al. Rapid molecular detection of tuberculosis and

rifampin resistance. NEJM 2010;363:1005–15.

Croften SJ, Chaulet P, Maher D. Guidelines for the

management of drug resistant tuberculosis. World Health

Organization, Geneva 1997;WHO/TB/96.210:1–47.

Karamat KA, Hayat S, Butt T, Abbasi S. Multidrug resistant

tuberculosis. Pak Armed F Med J 2000;50(2):114–6.

Heymann SJ, Brewer TF, Wilson ME, Fineberg HV. The

need for global action against multidrug resistant

tuberculosis. JAMA 1999;281:2138–41.

Raviglione MC, Smith IM. XDR tuberculosis–Implications

for global public health. N Engl J Med 2007;356:656–9.

Laidlaw M. Mycobacterium tubercle bacilli. In: Collee JG,

Duguid JP, Frazer AG, Marmion BP (eds). Mackie & Mc

Cartney Practical Medical Microbiology. 14th ed. London:

Churchill Livingstone;1989.p.399–424.

Ruiz-Serrano MJ, Alcalá L, Martínez L, Díaz M, Marín M,

González-Abad MJ, et al. In vitro activities of six

fluoroquinolones against 250 clinical isolates of M.

tuberculosis susceptible or resistant to first line

antituberculosis drugs. Antimicrobe Agents Chemother


Rastogi N, Labrousse V, Goh KS. In vitro activities of

fourteen antimicrobial agents against drug susceptible and

resistant clinical isolates of M. tuberculosis and comparative

intracellular activities against the virulent H37Rv strain in

human macrophages. Curr Microbiol 1996;33:167–75.

Tomioka H, Sato K, Kajitani H, Akaki T, Shishido S.

Comparative antimicrobial activity of the newly synthesized

quinolones WQ-3034, levofloxacin,. sparfloxacin and

ciprofloxacin against Mycobacterium tuberculosis and

Mycobacterium avium complex. Antimicrobial Agents

Chemother 2000;44:283–6.

Fattorini L, Iona E, Ricci ML, Thoresen OF, Orru G, Oggioni

MR, et al. Activity of 16 antimicrobial agents against drugresistant strains of Mycobacterium tuberculosis. Microb Drug

Resist 1999;5:265–70.

Hoffner SE, Gezelius L, Liljequist BO. In vitro activity of

fluorinated quinolones and macrolides against drug resistant M.

tuberculosis. J Antimicrobiol Chemother 1997;40:885–88.

Alangaden GJ, Lerner SA. The clinical use of

fluoroquinolones for the treatment of mycobacterial disease.

Clin Infec Dis 1997;25:1213–21.

Hoffner SE, Kallenius G. Susceptibility of streptomycin

resistant M. tuberculosis strains to amikacin. Eur J Clin

Microbiol Infec Dis 1988;7:188–90.

Pfyffer GE, BonatoDA, Ebrahimzadeh A, Gross W, Hotaling

J, Kornblum J, et al. Multicentre laboratory validation of

susceptibility testing of M. tuberculosis against classical

second-line and newer antimicrobial drugs by using the

radiometric Bactec 460 technique and the proportion method

with solid media. J Clin Microbiol 1999;37:3179–86.



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