Comparison of levofloxacin versus moxifloxacin for multidrug-resistant tuberculosis

American Journal of Respiratory and Critical Care Medicine, 10/03/2013

Koh WJ et al. – Levofloxacin (LFX) and moxifloxacin (MXF) are the two most frequently recommended fluoroquinolones for treatment of patients with multidrug–resistant tuberculosis (MDR–TB). The study aims to compare the effectiveness of LFX and MXF in terms of culture conversion after 3months of treatment for MDR–TB. The choice of LFX or MXF for treatment of patients with MDR–TB may not affect sputum culture conversion at 3months of treatment.

Methods

  • In this prospective multicenter randomized open label trial, the authors randomly assigned 182 patients with MDR-TB (sensitive to LFX and MXF) to receive either LFX (750mg/day; 90 patients) or MXF (400mg/day; 92 patients) with a background drug regimen.
  • The primary outcome was the proportion of patients who achieved sputum culture conversion at 3months of treatment.
  • Secondary outcomes were time to culture conversion and time to smear conversion, with data censored at 3months, and the proportions of adverse drug reactions.

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).

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