Choice between Levofloxacin and Moxifloxacin and Multidrug-Resistant Tuberculosis Treatment Outcomes.

Autor:	Kang YA; 1 Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea., Shim TS; 2 Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea., Koh WJ; 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Lee SH; 4 Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea., Lee CH; 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., Choi JC; 7 Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Republic of Korea., Lee JH; 8 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea., Jang SH; 9 Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea., Yoo KH; 10 Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea., Jung KH; 4 Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea., Kim KU; 11 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea., Choi SB; 12 Department of Internal Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea., Ryu YJ; 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., Kim KC; 14 Department of Internal Medicine, Catholic University of Daegu Hospital, Daegu, Republic of Korea., Um S; 15 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea., Kwon YS; 16 Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea., Kim YH; 17 Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea., Choi WI; 18 Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea., Jeon K; 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Hwang YI; 9 Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea., Kim SJ; 8 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea., Lee HK; 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., Heo E; 5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Yim JJ; 20 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Annals of the American Thoracic Society [Ann Am Thorac Soc] 2016 Mar; Vol. 13 (3), pp. 364-70.
DOI:	10.1513/AnnalsATS.201510-690BC
Abstrakt:	Rationale: 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. Objectives: 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. Measurements and Main 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).
Databáze:	MEDLINE
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