{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T08:58:35Z","timestamp":1769158715144,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T00:00:00Z","timestamp":1609718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Rifampicin is one of the most effective components of anti\u2010tuberculous therapy (ATT). Since rifampicin is a hepatic enzyme (CYP3A4) inducer, in a post\u2010renal transplant recipient, the dose of calcineurin inhibitors needs to be up\u2010regulated and frequently monitored. In resource\u2010limited (low\u2010 and lower\u2010middle\u2010income countries) setting this is not always feasible. Therefore, we evaluated a non\u2010rifampicin\u2010based ATT using levofloxacin in kidney transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively studied the medical records of renal transplant recipients diagnosed with tuberculosis in our institute between 2014 and 2017. After a brief discussion with patients regarding the nature and course of ATT, those who opted for a non\u2010rifampicin based therapy due to financial constraints were included in the study and followed for a minimum of 6 months period after the completion of ATT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of the 550 renal transplant recipients, 67 (12.2%) developed tuberculosis after a median period of 24 (1\u2010228) months following transplantation, of them, 64 patients opted for non\u2010rifampicin\u2010based ATT. The mean age was 37.6\u2009years. Only 25% were given anti\u2010thymocyte globulin based induction, while the majority (56; 87.5%) of them were on tacrolimus\u2010based triple\u2010drug maintenance therapy. Extrapulmonary tuberculosis was noted in 33% of cases, while 12 (18.7%) had disseminated disease. The median duration of treatment was 12\u2009months and the cure rate of 93.7% (n = 60) was achieved at the end of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Levofloxacin based ATT appears to be a safe and effective alternative of rifampicin in kidney transplant recipients who cannot afford heightened tacrolimus dosage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13816","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T06:43:54Z","timestamp":1604645034000},"page":"178-184","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Levofloxacin based <scp>non\u2010rifampicin anti\u2010tuberculous<\/scp> therapy: An effective alternative in renal transplant recipients in resource limited setting"],"prefix":"10.1111","volume":"26","author":[{"given":"Krishan Lal","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sahil","family":"Bagai","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harsha","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valliappan","family":"Muthu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Rathi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harbir S","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Renal Transplant Surgery Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.0600031148.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199601270-00008"},{"key":"e_1_2_7_4_1","first-page":"39","article-title":"Section iv: long\u2010term management of the transplant recipient. 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