title: Choice between Levofloxacin and Moxifloxacin and Multidrug-Resistant Tuberculosis Treatment Outcomes.
abstract: BACKGROUND
  We previously showed that the choice of levofloxacin or moxifloxacin for the treatment of patients with fluoroquinolone-sensitive multidrug-resistant tuberculosis (MDR-TB) did not affect sputum culture conversion at 3 months of treatment.
  
  
  OBJECTIVE
  To compare final treatment outcomes between patients with MDR-TB randomized to levofloxacin or moxifloxacin.
  
  
  METHODS
  A total of 151 participants with MDR-TB who were included for the final analysis in our previous trial were followed through the end of treatment. Treatment outcomes were compared between 77 patients in the levofloxacin group and 74 in the moxifloxacin group, based on the 2008 World Health Organization definitions as well as 2013 revised definitions of treatment outcomes. In addition, the time to culture conversion was compared between the two groups.
  
  
  RESULTS
  Treatment outcomes were not different between the two groups, based on 2008 World Health Organization definitions as well as 2013 definitions. With 2008 definitions, cure was achieved in 54 patients (70.1%) in the levofloxacin group and 54 (73.0%) in the moxifloxacin group (P = 0.72). Treatment success rates, including cure and treatment completed, were not different between the two groups (87.0 vs. 81.1%, P = 0.38). With 2013 definitions, cure rates (83.1 vs. 78.4%, P = 0.54) and treatment success rates (84.4 vs. 79.7%, P = 0.53) were also similar between the levofloxacin and moxifloxacin groups. Time to culture conversion was also not different between the two groups (27.0 vs. 45.0 d, P = 0.11 on liquid media; 17.0 vs. 42.0 d, P = 0.14 on solid media). Patients in the levofloxacin group had more adverse events than those in the moxifloxacin group (79.2 vs. 63.5%, P = 0.03), especially musculoskeletal ones (37.7 vs. 14.9%, P = 0.001).
  
  
  CONCLUSIONS
  The choice of levofloxacin or moxifloxacin made no difference to the final treatment outcome among patients with fluoroquinolone-sensitive MDR-TB. Clinical trial registered with www.clinicalrials.gov (NCT01055145).
authors.affiliation: 1 Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Ae
authors.initials: YA
authors.lastname: Kang
authors.affiliation: 2 Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Shim
authors.affiliation: 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.affiliation: 4 Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Seung Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: 5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.|6 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Chang-Hoon
authors.initials: CH
authors.lastname: Lee
authors.affiliation: 7 Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Chol
authors.initials: JC
authors.lastname: Choi
authors.affiliation: 8 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: 9 Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Jang
authors.affiliation: 10 Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang Ha
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: 4 Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Ki Hwan
authors.initials: KH
authors.lastname: Jung
authors.affiliation: 11 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
authors.forename: Ki Uk
authors.initials: KU
authors.lastname: Kim
authors.affiliation: 12 Department of Internal Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea.
authors.forename: Sang Bong
authors.initials: SB
authors.lastname: Choi
authors.affiliation: 13 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Medical Center and Ewha Medical Research Institute, Ewha Womans University, School of Medicine, Mokdong Hospital, Seoul, Republic of Korea.
authors.forename: Yon Ju
authors.initials: YJ
authors.lastname: Ryu
authors.affiliation: 14 Department of Internal Medicine, Catholic University of Daegu Hospital, Daegu, Republic of Korea.
authors.forename: Kyung Chan
authors.initials: KC
authors.lastname: Kim
authors.affiliation: 15 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea.
authors.forename: Soojung
authors.initials: S
authors.lastname: Um
authors.affiliation: 16 Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kwon
authors.affiliation: 17 Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Yee Hyung
authors.initials: YH
authors.lastname: Kim
authors.affiliation: 18 Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Won-Il
authors.initials: WI
authors.lastname: Choi
authors.affiliation: 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: 9 Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Hwang
authors.affiliation: 8 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Se Joong
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: 19 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital Inje University College of Medicine, Busan, Republic of Korea; and.
authors.forename: Hyun-Kyung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: 5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Heo
authors.affiliation: 20 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Joon
authors.initials: JJ
authors.lastname: Yim
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D064704:Levofloxacin / Q000008:administration & dosage* / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D064704:Levofloxacin; D000077266:Moxifloxacin
keywords: fluoroquinolones; levofloxacin; moxifloxacin; multidrug-resistant tuberculosis