Comparative Roles of Levofloxacin and Ofloxacin in the Treatment of Multidrug-Resistant Tuberculosis

Yew, Wing Wai; Chan, Chi Kuen; Leung, Chi Chiu; Chau, CH; Tam, Cheuk Ming; Wong, Puisan; Lee, Joseph

doi:10.1378/chest.124.4.1476

Cited by 114 publications

(76 citation statements)

References 10 publications

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“…A prolonged duration of treatment may lead to poor adherence, higher cost and undue toxicity. In our previous studies, we found that the use of ofloxacin/levofloxacin-containing regimens had a favourable effect on MDR-TB outcome [3,4]. Our studies also suggested that shorter treatment duration (mean duration 14 months) might be feasible in selected MDR-TB patients.…”

Section: Shorter Treatment Duration For Selected Patients With Multidsupporting

confidence: 54%

Shorter treatment duration for selected patients with multidrug-resistant tuberculosis

Leung

Yew

Leung

et al. 2011

European Respiratory Journal

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Section: Shorter Treatment Duration For Selected Patients With Multidsupporting

confidence: 54%

Shorter treatment duration for selected patients with multidrug-resistant tuberculosis

Leung

Yew

Leung

et al. 2011

European Respiratory Journal

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“…The lower frequency of adverse reactions to ofloxacin is important [6,8,9,19,20]. Furthermore, the low relapse rate is a crucial finding.…”

Section: Outcome Of Pulmonary Mdr-tbmentioning

confidence: 99%

“…The most potent are moxifloxacin and gatifloxacin, followed by sparfloxacin and levofloxacin [22,23]. A retrospective study from Hong Kong [20] revealed that levofloxacin was more efficacious than ofloxacin when incorporated into multidrug regimens used for the treatment of MDR-TB and should be the drug of choice in the treatment of MDR-TB. Moxifloxacin is probably even more promising in the treatment of TB [25][26][27][28][29].…”

Section: Outcome Of Pulmonary Mdr-tbmentioning

confidence: 99%

Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study

Chiang¹,

Enarson²,

Yu³

et al. 2006

European Respiratory Journal

104

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A retrospective study was performed to determine factors associated with the outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan.All patients newly diagnosed with pulmonary MDR-TB in a referral centre from 1992-1996 were enrolled and their outcome over the subsequent 6 yrs was determined.A total of 299 patients were identified, comprising 215 (71.9%) males and 84 (28.1%) females with a mean age of 47.3 yrs. The patients received a mean of 3.7 effective drugs. Out of the 299 patients, 153 (51.2%) were cured, 31 (10.4%) failed, 28 (9.4%) died and 87 (29.1%) defaulted. Of the 125 patients receiving second-line drugs with ofloxacin, 74 (59.2%) were cured. Those who received ofloxacin had a lower risk of relapse than those receiving only first-line drugs (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.03-0.81) and a lower risk of TB-related death than those receiving second-line drugs but not ofloxacin (adjusted HR 0.50, 95% CI 0.31-0.82).In conclusion, multidrug-resistant tuberculosis patients who received ofloxacin were more likely to be cured, and were less likely to die, fail or relapse. The utility of new-generation fluoroquinolones, such as moxifloxacin, in the treatment of multidrug-resistant tuberculosis needs to be evaluated. Default from treatment is a major challenge in the treatment of multidrugresistant tuberculosis.

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“…Основная роль в эф фективности IIБ РХТ определяется бактерицидным действием фторхинолонов, их синергетическим действием с другими основными препаратами и низ кой частотой нежелательных эффектов [1-3, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

Section: вюмишин аскононецunclassified

Evidence-based efficacy of chemotherapy and stability of clinical cure in newly diagnosed patients with cavitary pulmonary tuberculosis

Мишин¹,

Kononets²

2012

Pulʹmonologiâ (Mosk.)

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Клиническое излечение впервые выявленных боль ных деструктивным туберкулезом легких является актуальной проблемой фтизиатрии в виду тяжелого течения заболевания, высокого риска развития мно жественной лекарственной устойчивости (МЛУ) ми кобактерий туберкулеза (МБТ), возможности фор мирования хронического фиброзно кавернозного туберкулеза с высокой эпидемиологической опас ностью для здорового населения [1][2][3][4].Для лечения впервые выявленных больных де структивным туберкулезом легких в соответствии с приказом МЗ РФ № 109 от 21.03.03 [5] и Нацио нальным руководством по фтизиатрии 2007 г. [3] определен I режим химиотерапии (I РХТ), состоя щий из основных противотуберкулезных препаратов: изониазида, рифампицина, пиразинамида, стрепто мицина (этамбутола). При этом клиническое излече ние пациентов, зарегистрированных в 2009 г., соста вило всего 31,5 %, а фиброзно кавернозный туберку лез у них сформировался в 45,5 % случаев [6][7][8].Столь низкая эффективность лечения связана, в первую очередь, с повсеместным использованием оказавшегося неадекватным в РФ I РХТ [2,3,9], применение которого только за 7 лет привело к зна чительному увеличению первичной и вторичной МЛУ МБТ. SummaryA randomized multi center clinical study of chemotherapy efficacy, clinical cure and early recurrence rate involved 240 newly diagnosed patients with cavitary pulmonary tuberculosis treated in municipal and penitentiary medical facilities. Given the primary multiple drug resistance (MDR) of 22.5-33.3 %, intensive chemotherapy with isoniazid, rifampicin, pyrazinamide, ethambutol, kanamycin (or amikacin) and ofloxacin (or lev ofloxacin) allowed to achieve sputum conversion in 100 % of smear positive patients using sputum microscopy and in 89.2 % using sputum culture, cavity closure in 71.7 %, and clinical cure in 94.2 % with early recurrence rate of 2.6 % in comparison to 54.2, 45.8, 45.8, 65 and 20.5 % respectively in patients treated with isoniazid, rifampicin, pyrazinamide and ethambutol. Lung fibrocavitary lesions with high level of MDR developed in 55 % of patients and were associated with high cost of treatment due to the need in expensive salvage chemotherapy regimens and high tech surgical inter ventions. Key words: pulmonary tuberculosis, drug resistance, chemotherapy, evidence based medicine. РезюмеБыло проведено рандомизированное многоцентровое клиническое исследование эффективности химиотерапии, клинического излече ния и частоты ранних рецидивов у 240 впервые выявленных больных деструктивным туберкулезом легких в гражданских и пенитенци арных противотуберкулезных учреждениях. Доказано, что при уровне первичной множественной лекарственной устойчивости (МЛУ) 22,5-33,3 % режим химиотерапии изониазидом, рифампицином, пиразинамидом, этамбутолом, канамицином (амикацин) и офлокса цином (левофлоксацин) в интенсивной фазе лечения позволяет добиться прекращения бактериовыделения по результатам микроско пии мокроты у 100 % больных и по посеву -у 89,2 %, закрытия каверн -у 71,7 %, клинического излечения -у 94,2 % и ранних реци дивов -у 2,6 % п...

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Comparative Roles of Levofloxacin and Ofloxacin in the Treatment of Multidrug-Resistant Tuberculosis

Cited by 114 publications

References 10 publications

Shorter treatment duration for selected patients with multidrug-resistant tuberculosis

Shorter treatment duration for selected patients with multidrug-resistant tuberculosis

Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study

Evidence-based efficacy of chemotherapy and stability of clinical cure in newly diagnosed patients with cavitary pulmonary tuberculosis

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