Comparison of Levofloxacin versus Moxifloxacin for Multidrug-Resistant Tuberculosis
Authors
Won-Jung Koh ; Seung Heon Lee ; Young Ae Kang ; Chang-Hoon Lee ; Jae Chol Choi ; Jae Ho Lee ; Seung Hun Jang ; Kwang Ha Yoo ; Ki Hwan Jung ; Ki Uk Kim ; Sang Bong Choi ; Yon Ju Ryu ; Kyung Chan Kim ; Soojung Um ; Yong Soo Kwon ; Yee Hyung Kim ; Won-Il Choi ; Kyeongman Jeon ; Yong Il Hwang ; Se Joong Kim ; Young Seok Lee ; Eun Young Heo ; Juhee Lee ; Yeo Woon Ki ; Tae Sun Shim ; Jae-Joon Yim
Citation
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol.188(7) : 858-864, 2013
RATIONALE: Levofloxacin (LFX) and moxifloxacin (MXF) are the two most frequently recommended fluoroquinolones for treatment of patients with multidrug-resistant tuberculosis (MDR-TB). However, studies comparing the effectiveness of LFX and MXF among patients with MDR-TB are lacking.
OBJECTIVES: To compare the effectiveness of LFX and MXF in terms of culture conversion after 3 months of treatment for MDR-TB.
METHODS: In this prospective multicenter randomized open label trial, we randomly assigned 182 patients with MDR-TB (sensitive to LFX and MXF) to receive either LFX (750 mg/day; 90 patients) or MXF (400 mg/day; 92 patients) with a background drug regimen. The primary outcome was the proportion of patients who achieved sputum culture conversion at 3 months of treatment. Secondary outcomes were time to culture conversion and time to smear conversion, with data censored at 3 months, and the proportions of adverse drug reactions.
MEASUREMENTS AND MAIN RESULTS: At 3 months of treatment, 68 (88.3%) of the 77 patients in the LFX group and 67 (90.5%) of the 74 in the MXF group showed conversion to negative sputum cultures (odds ratio for LFX compared with MXF, 0.78; 95% confidence interval, 0.27-2.20). Adverse drug reactions were reported in six patients (7.7%) in the LFX group and four (5.2%) in the MXF group (P = 0.75).
CONCLUSIONS: The choice of LFX or MXF for treatment of patients with MDR-TB may not affect sputum culture conversion at 3 months of treatment. Clinical trial registered with www.clinicaltrials.gov (NCT 01055145).