Young Ae Kang1, Tae Sun Shim2, Won-Jung Koh3, Seung Heon Lee4, Chang-Hoon Lee5,6, Jae Chol Choi7, Jae Ho Lee8, Seung Hun Jang9, Kwang Ha Yoo10, Ki Hwan Jung4, Ki Uk Kim11, Sang Bong Choi12, Yon Ju Ryu13, Kyung Chan Kim14, Soojung Um15, Yong-Soo Kwon16, Yee Hyung Kim17, Won-Il Choi18, Kyeongman Jeon3, Yong Il Hwang9, Se Joong Kim8, Hyun-Kyung Lee19, Eunyoung Heo5, Jae-Joon Yim20. 1. 1 Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. 2 Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 3. 3 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. 4 Division of Pulmonary, Sleep, and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea. 5. 5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 6. 6 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 7. 7 Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Republic of Korea. 8. 8 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 9. 9 Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. 10. 10 Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea. 11. 11 Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea. 12. 12 Department of Internal Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea. 13. 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. 14. 14 Department of Internal Medicine, Catholic University of Daegu Hospital, Daegu, Republic of Korea. 15. 15 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dong-A University Medical Center, Busan, Republic of Korea. 16. 16 Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea. 17. 17 Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. 18. 18 Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea. 19. 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. 20. 20 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
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 tolevofloxacin 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).
RCT Entities:
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).
Authors: Elise D Pieterman; Lindsey H M Te Brake; Gerjo J de Knegt; Aart van der Meijden; Jan-Willem C Alffenaar; Hannelore I Bax; Rob E Aarnoutse; Jurriaan E M de Steenwinkel Journal: Antimicrob Agents Chemother Date: 2018-08-27 Impact factor: 5.191
Authors: Mohammad H Al-Shaer; Wael A Alghamdi; Abdullah Alsultan; Guohua An; Shahriar Ahmed; Yosra Alkabab; Sayera Banu; Ketevan Barbakadze; Eric Houpt; Maia Kipiani; Lali Mikiashvili; J Peter Cegielski; Russell R Kempker; Scott K Heysell; Charles A Peloquin Journal: Antimicrob Agents Chemother Date: 2019-06-24 Impact factor: 5.191
Authors: Helen R Stagg; Graham H Bothamley; Jennifer A Davidson; Heinke Kunst; Maeve K Lalor; Marc C Lipman; Miranda G Loutet; Stefan Lozewicz; Tehreem Mohiyuddin; Aula Abbara; Eliza Alexander; Helen Booth; Dean D Creer; Ross J Harris; Onn Min Kon; Michael R Loebinger; Timothy D McHugh; Heather J Milburn; Paramita Palchaudhuri; Patrick P J Phillips; Erik Schmok; Lucy Taylor; Ibrahim Abubakar Journal: Eur Respir J Date: 2019-10-10 Impact factor: 16.671
Authors: Samiksha Ghimire; Samriddhi Karki; Bhagwan Maharjan; Jos G W Kosterink; Daan J Touw; Tjip S van der Werf; Bhabana Shrestha; Jan-Willem Alffenaar Journal: BMJ Open Respir Res Date: 2020-08