Gatifloxacin is superior to levofloxacin and moxifloxacin in shorter treatment regimens for multidrug-resistant TB

A. Van Deun, T. Decroo, C. Kuaban, J. Noeske, A. Piubello, K. J. M. Aung, H. L. Rieder

Research output: Contribution to journalA1: Web of Science-article

Abstract

SETTING: Data were collected from patients starting one of the shorter treatment regimens (STRs) for multidrug-resistant tuberculosis (MDR-TB) in Bangladesh, Niger or Cameroon.

OBJECTIVE : To estimate the effect of either a gatifloxacin (GFX), moxifloxacin (MFX) or levofloxacin (LVX) based STR on bacteriological effectiveness.

DESIGN: Retrospective study of prospectively collected data.

RESULTS : Among 1530 patients, bacteriological effectiveness was 96.7% overall. Stratified by treatment with a GFX-, LVX- or MFX-based regimen effectiveness was respectively 97.5%, 95.5% and 94.7%. Compared to those on a GFX-based regimen, the estimated summary odds ratio of having an adverse outcome was more than double (OR 2.05, 95% CI 1.09-3.90) in patients treated with either an LVX-based or MFX-based regimen. After adjusting for initial resistance, patients treated with an LVX-based regimen and MFX-based regimen had respectively a 4.5- and 8.4-fold times larger odds of an adverse bacteriological outcome. None among 859 patients at risk treated with a GFX-based compared to at least 4 of 228 among those on an MFX-based regimen acquired fluoroquinolone resistance.

CONCLUSION: GFX-based regimens had superior bacteriological effectiveness than MFX-based or LVX-based regimens. As GFX is currently unavailable in most MDR-TB programs, its reintroduction should be prioritised.

Original languageEnglish
JournalInternational Journal of Tuberculosis and Lung Disease
Volume23
Issue number9
Pages (from-to)965-971
Number of pages8
ISSN1027-3719
DOIs
Publication statusPublished - 2019

Keywords

  • gatifloxacin
  • moxifloxacin
  • levofloxacin
  • core drug
  • bacteriological effectiveness
  • TUBERCULOSIS TREATMENT

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