Comparison of levofloxacin versus moxifloxacin for multidrug-resistant tuberculosis.
BACKGROUND
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.


OBJECTIVE
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.


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).
1 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Won-Jung
WJ
Koh
Seung Heon
SH
Lee
Young Ae
YA
Kang
Chang-Hoon
CH
Lee
Jae Chol
JC
Choi
Jae Ho
JH
Lee
Seung Hun
SH
Jang
Kwang Ha
KH
Yoo
Ki Hwan
KH
Jung
Ki Uk
KU
Kim
Sang Bong
SB
Choi
Yon Ju
YJ
Ryu
Kyung
K
Chan Kim
Soojung
S
Um
Yong Soo
YS
Kwon
Yee Hyung
YH
Kim
Won-Il
WI
Choi
Kyeongman
K
Jeon
Yong Il
YI
Hwang
Se Joong
SJ
Kim
Young Seok
YS
Lee
Eun Young
EY
Heo
Juhee
J
Lee
Yeo Woon
YW
Ki
Tae Sun
TS
Shim
Jae-Joon
JJ
Yim
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D024841:Fluoroquinolones; D006801:Humans; D064704:Levofloxacin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D000077266:Moxifloxacin; D011446:Prospective Studies; D011804:Quinolines / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D056910:Republic of Korea; D013183:Sputum / Q000187:drug effects / Q000382:microbiology; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D064704:Levofloxacin; D000077266:Moxifloxacin