title: The bactericidal activity of moxifloxacin in patients with pulmonary tuberculosis.
abstract: Patients in whom acid-fast bacilli smear-positive pulmonary tuberculosis was newly diagnosed were randomized to receive 400 mg moxifloxacin, 300 mg isonaizid, or 600 mg rifampin daily for 5 days. Sixteen-hour overnight sputa collections were made for the 2 days before and for 5 days of monotherapy. Bactericidal activity was estimated by the time taken to kill 50% of viable bacilli (vt50) and the fall in sputum viable count during the first 2 days designated as the early bactericidal activity (EBA). The mean vt50 of moxifloxacin was 0.88 days (95% confidence interval [CI], 0.43-1.33 days) and the mean EBA was 0.53 (95% CI 0.28-0.79). For the isoniazid group, the mean vt50 was 0.46 days (95% CI, 0.31-0.61 days) and the mean EBA was 0.77 (95% CI, 0.54-1.00). For rifampin, the mean vt50 was 0.71 days (95% CI, 0.48-0.95 days) and the mean EBA was 0.28 (95% CI, 0.15-0.41). Using the EBA method, isoniazid was significantly more active than rifampin (p < 0.01) but not moxifloxacin. Using the vt50 method, isoniazid was more active than both rifampin and moxifloxacin (p = 0.03). Moxifloxacin has an activity similar to rifampin in human subjects with pulmonary tuberculosis, suggesting that it should undergo further assessment as part of a short course regimen for the treatment of drug-susceptible tuberculosis.
authors.affiliation: Department of Medical Microbiology, Royal Free and University London College Medical Schools, Royal Free Campus, London, UK.
authors.forename: Roly D
authors.initials: RD
authors.lastname: Gosling
authors.forename: Leonard O
authors.initials: LO
authors.lastname: Uiso
authors.forename: Noel E
authors.initials: NE
authors.lastname: Sam
authors.forename: Emily
authors.initials: E
authors.lastname: Bongard
authors.forename: Esther G
authors.initials: EG
authors.lastname: Kanduma
authors.forename: Mramba
authors.initials: M
authors.lastname: Nyindo
authors.forename: Richard W
authors.initials: RW
authors.lastname: Morris
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Gillespie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage*; D001372:Aza Compounds / Q000008:administration & dosage*; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D020128:Inhibitory Concentration 50; D007538:Isoniazid / Q000008:administration & dosage*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D000077266:Moxifloxacin; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011804:Quinolines / Q000008:administration & dosage*; D012293:Rifampin / Q000008:administration & dosage*; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000904:Antibiotics, Antitubercular; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin; D007538:Isoniazid; D012293:Rifampin