Retrospective comparison of levofloxacin and moxifloxacin on multidrug-resistant tuberculosis treatment outcomes

Korean J Intern Med. 2011 Jun;26(2):153-9. doi: 10.3904/kjim.2011.26.2.153. Epub 2011 Jun 1.

Abstract

Background/aims: To compare the effect of levofloxacin and moxifloxacin on treatment outcomes among patients with multidrug-resistant tuberculosis (MDR-TB).

Methods: A retrospective analysis of 171 patients with MDR-TB receiving either levofloxacin or moxifloxacin was performed. Treatment responses were categorized into treatment success (cured and treatment completed) or adverse treatment outcome (death, failure, and relapsed).

Results: The median age of the patients was 42.0 years. Approximately 56% of the patients were male. Seventeen patients had extensively drug-resistant tuberculosis, and 20 had a surgical resection. A total of 123 patients (71.9%) received levofloxacin for a median 594 days, and 48 patients (28.1%) received moxifloxacin for a median 673 days. Other baseline demographic, clinical, and radiographic characteristics were similar between the two groups. The moxifloxacin group had a significantly higher number of resistant drugs (p < 0.001) and a higher incidence of resistance to ofloxacin (p = 0.005) in the drug sensitivity test. The treatment success rate was 78.9% in the levofloxacin group and 83.3% in the moxifloxacin group (p = 0.42). Adverse reactions occurred at similar rates in the groups (p = 0.44). Patients in the moxifloxacin group were not more likely to have treatment success than those in the levofloxacin group (adjusted odds ratio, 0.76; 95% confidence interval, 0.24 to 2.43; p = 0.65).

Conclusions: Both levofloxacin and moxifloxacin showed equivalent efficacy for treating MDR-TB.

Keywords: Levofloxacin; Moxifloxacin; Quinolones; Tuberculosis; Tuberculosis, multidrug-resistant.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antitubercular Agents / adverse effects
  • Antitubercular Agents / therapeutic use*
  • Aza Compounds / adverse effects
  • Aza Compounds / therapeutic use*
  • Case-Control Studies
  • Chi-Square Distribution
  • Drug Resistance, Multiple, Bacterial*
  • Drug Therapy, Combination
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • Extensively Drug-Resistant Tuberculosis / microbiology
  • Extensively Drug-Resistant Tuberculosis / mortality
  • Female
  • Fluoroquinolones
  • Humans
  • Levofloxacin*
  • Logistic Models
  • Male
  • Middle Aged
  • Moxifloxacin
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / pathogenicity
  • Odds Ratio
  • Ofloxacin / adverse effects
  • Ofloxacin / therapeutic use*
  • Quinolines / adverse effects
  • Quinolines / therapeutic use*
  • Recurrence
  • Remission Induction
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Multidrug-Resistant / mortality

Substances

  • Antitubercular Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Levofloxacin
  • Ofloxacin
  • Moxifloxacin