title: Treatment outcomes and moxifloxacin susceptibility in ofloxacin-resistant multidrug-resistant tuberculosis.
abstract: METHODS
  A tertiary referral centre in Seoul, South Korea.
  
  
  OBJECTIVE
  To investigate the effect of moxifloxacin (MFX) susceptibility and later-generation fluoroquinolone (FQ) use on the treatment outcomes of ofloxacin (OFX) resistant multidrug-resistant tuberculosis (MDR-TB).
  
  
  METHODS
  Of 223 patients diagnosed with MDR-TB between January 2006 and December 2012, 70 (31.4%) patients with OFX-resistant MDR-TB were enrolled in this retrospective cohort study. Their treatment outcomes were analysed.
  
  
  RESULTS
  The mean age (standard deviation) of the 70 patients was 40.6 (12.9) years; 43 (61.4%) were male and 26 (37.1%) had extensively drug-resistant TB. Of the 70 patients, 22 (31.4%) had MFX-susceptible TB, while the remaining 48 (68.6%) were MFX-resistant. The MFX-susceptible and -resistant groups were comparable in terms of baseline characteristics (including age, sex and radiological severity), and respectively 90.9% (20/22) and 70.8% (34/48) were treated with later-generation FQ-containing regimens (P = 0.074; mainly MFX [40/54, 74.1%]). Treatment success was achieved in 72.7% (16/22) of the MFX-susceptible patients and in 41.7% (20/48) of the MFX-resistant patients (P = 0.021). Treatment failure was significantly higher in the MFX-resistant group (41.7% [20/48] vs. 9.1% [2/22]; P = 0.006).
  
  
  CONCLUSIONS
  Patients with OFX-resistant MDR-TB had significantly better treatment outcomes when susceptible to MFX. This probably reflects the effect of later-generation FQ treatment.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: K-W
authors.initials: KW
authors.lastname: Jo
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: S-D
authors.initials: SD
authors.lastname: Lee
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: D S
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: T S
authors.initials: TS
authors.lastname: Shim
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D000077266:Moxifloxacin; D015242:Ofloxacin / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D015242:Ofloxacin; D000077266:Moxifloxacin