Moxifloxacin
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Liver injury: case report A 21-year-old man developed liver injury during treatment with moxifloxacin for multidrug-resistant tuberculosis (TB) [time to reaction onset and outcome not stated]. The man presented with impaired general condition, weight loss and abdominal epigastric pain to the emergency department of Bichat Hospital, France. After investigations, a diagnosis of miliary TB was made. Then, he started receiving anti-TB treatment with isoniazid, rifampicin, ethambutol and levofloxacin. However, a rapid molecular drug susceptibility testing subsequently showed resistance to isoniazid and rifampicin. Therefore, he started receiving a new regimen comprised of IV moxifloxacin 400 mg/24h, along with ethambutol, linezolid and amikacin. After one month of hospital admission, his condition worsened with a sudden cardiogenic shock, which revealed a probable pre-existing hypertrophic cardiomyopathy. Subsequently, he was transferred to the ICU and placed under invasive mechanical ventilation and received veno-arterial extracorporeal life support. Following one month, a left ventricular assist device was implanted. Later, he was noted to have toxic liver injury (plasma transaminases: 10N), and it was suspected to be associated with moxifloxacin. Therefore, moxifloxacin was replaced with bedaquiline. In the meantime, he received antifungal treatment with isavuconazole and micafungin for a fungemia secondary to Trichosporon inking, Candida albicans and Candida glabrata. On day 80, he died due to intracerebral haemorrhage. Dang E, et al. Plasma pharmacokinetics of bedaquiline administered by nasogastric tube in an intensive care unit. International Journal of Tuberculosis and Lung Disease 24: 803519176 110-112, No. 1, Jan 2020. Available from: URL: http://doi.org/10.5588/ijtld.19.0221
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Reactions 5 Dec 2020 No. 1833
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