Moxifloxacin May Accelerate Tuberculosis Cure by Months

Brazilian study suggests enhanced treatment can shorten TB cure from six to two months
By Jeff Muise
HealthDay Reporter

FRIDAY, April 3 (HealthDay News) -- The standard first-line tuberculosis treatment regimen enhanced with the fluoroquinolone moxifloxacin can cure the disease three times faster than standard treatment alone, researchers report in the April 4 issue of The Lancet.

Marcus B. Conde, M.D., of the Instituto de Doencas do Torax/Hospital Clementino Fraga Filho in Rio de Janeiro, Brazil, and colleagues conducted a phase II, double-blind, randomized trial of moxifloxacin in a treatment regimen for sputum smear-positive tuberculosis. The 170 participants all received isoniazid, rifampicin, and pyrazinamide at standard doses and were randomized to additionally receive moxifloxacin (400 mg) with an ethambutol placebo (n=85) or ethambutol (15 to 20 mg/kg) with a moxifloxacin placebo (n=85). Medication was administered five days per week for eight weeks.

Results were assessed at the eight-week endpoint using modified intention-to-treat analysis. Due to culture contamination and other factors, 146 patients (moxifloxacin, n=74; ethambutol, n=72) were included in the final analysis. The researchers found conversion to sputum smear-negative occurred in 59 patients (80 percent) in the moxifloxacin group compared with 45 (63 percent) in the ethambutol group. The authors note that standard treatment alone takes six months to effect a cure.

"The results of our trial have substantial implications for future trials. First, the improved culture conversion rates found after eight weeks in the experimental group suggest that moxifloxacin, in combination with other first-line antituberculosis drugs, could shorten the time needed to cure tuberculosis by several months," the authors write.

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