Moxifloxacin plus standard first-line therapy in the treatment of pulmonary tuberculosis: A meta-analysis

Chen, Zhi; Liang, Juhua; Wang, Jinhe; Feng, Shisheng; Zhang, Guangyu

doi:10.1016/j.tube.2015.03.014

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…An earlier meta-analysis evaluated the clinical outcomes of moxifloxacin plus standard first-line treatment for tuberculosis (26). Patients in the control group were given a combination of pyrazinamide (Z), isoniazid (H), and rifampin (R), with or without ethambutol (Ethambutol, E).…”

Section: Discussionmentioning

confidence: 99%

Moxifloxacin is a safe and effective candidate agent for tuberculosis treatment: a meta-analysis of randomized controlled trials

Sun¹,

Fan²

2021

Ann Palliat Med

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Background: Moxifloxacin is a fourth-generation fluoroquinolone that has shown good antibacterial activity against both gram-positive cocci and gram-negative bacteria. The purpose of this study was to evaluate the safety and efficacy of moxifloxacin in the drug treatment regimen of patients with tuberculosis. Methods:We conducted an electronic database search of the PubMed, Embase, the Cochrane Controlled Center Register of Controlled Trials (CENTRAL), Web of Science, Baidu Scholar, and Google Scholar for literature related to clinical randomized controlled trials (RCTs) of tuberculosis patients (from the date of inception of the database to September 25, 2020). The experimental group received moxifloxacin while the control group did not use moxifloxacin. After literature screening, data extraction, and literature quality evaluation, the included studies were meta-analyzed using RevMan software 5.1.Results: In total, 13 RCTs involving 7,774 patients were included in this meta-analysis. The negative rate of sputum culture in the experimental group (which received moxifloxacin) was significantly higher than that of the control group after 2 months of treatment [relative risk (RR) =1.12, 95% confidence interval (CI):1.06-1.18, P<0.0001]. Treatment-related complications in the experimental group were significantly greater than those in the control group (RR =1.34, 95% CI: 1.07-1.67, P=0.01). There was no significant difference in the incidence of serious complications between the two groups (RR =1.09, 95% CI: 0.90-1.33, P=0.38). In addition, there were no significant differences in mortality and recurrence rate between the two groups (RR

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Section: Discussionmentioning

confidence: 99%

Moxifloxacin is a safe and effective candidate agent for tuberculosis treatment: a meta-analysis of randomized controlled trials

Sun¹,

Fan²

2021

Ann Palliat Med

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“…A previous meta-analysis assessed the clinical outcomes of moxifloxacin plus standard first-line therapy for the treatment of pulmonary TB (Chen et al, 2015). The control group patients in that study were given the combination of Z, H, and R, with or without E, which was called the standard regimen; the case group patients were given this standard regimen plus moxifloxacin.…”

Section: Discussionmentioning

confidence: 99%

Moxifloxacin is an effective and safe candidate agent for tuberculosis treatment: a meta-analysis

Chen

et al. 2017

International Journal of Infectious Diseases

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“…Previous systematic reviews have reported no significant difference in the rate of sputum mycobacterial culture conversion at 2 months of treatment between the fluoroquinolone-containing regimen and standard regimen, whereas relapse or treatment failure was not fully evaluated because of the lack of available studies [ 16 , 17 ]. In terms of safety, only nausea was more frequently associated with the fluoroquinolone-containing regimen [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, no significant differences in the sputum culture conversion rate at 2 months were found between the fluoroquinolone-containing regimen and standard regimen in a previous systematic review and meta-analysis [ 16 , 17 ]. Those studies did not include recent RCTs in which the fluoroquinolone-containing regimens with gatifloxacin or moxifloxacin and treatment duration of 4 months [ 18 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness and Safety of Fluoroquinolone-Containing Regimen as a First-Line Treatment for Drug-Sensitive Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis

Lee

Kim

et al. 2016

PLoS ONE

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BackgroundFluoroquinolone is recommended as a pivotal antituberculous agent for treating multi-drug-resistant pulmonary tuberculosis. However, its effectiveness as first-line treatment remains controversial. The present study was conducted to validate the fluoroquinolone-containing regimen for drug-sensitive pulmonary tuberculosis.MethodsWe searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials until June 5, 2015. Randomized controlled trials (RCTs) that compared antituberculous regimens containing fluoroquinolone with the standard regimen were included.ResultsEleven RCTs that included 6,334 patients were selected. Fluoroquinolone-containing regimens had a higher rate of sputum culture conversion at 2 months of treatment (M-H fixed odds ratio [OR], 1.36; 95% confidence interval [CI], 1.20–1.54). However, the outcomes were less favorable (M-H fixed OR, 0.69; 95% CI, 0.59–0.82) and the associated total adverse events were more frequent (M-H fixed OR, 1.84; 95% CI, 1.46–2.31) in the fluoroquinolone-containing regimen group, without a significant heterogeneity according to treatment duration. Treatment with the fluoroquinolone-containing regimen for 4 months showed a higher relapse rate.ConclusionsDespite a higher culture conversion rate at 2 months of treatment, the fluoroquinolone-containing regimen had limitations, including less favorable outcomes and more adverse events, as the first-line therapy for drug-sensitive pulmonary tuberculosis.

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Moxifloxacin plus standard first-line therapy in the treatment of pulmonary tuberculosis: A meta-analysis

Cited by 12 publications

References 9 publications

Moxifloxacin is a safe and effective candidate agent for tuberculosis treatment: a meta-analysis of randomized controlled trials

Moxifloxacin is a safe and effective candidate agent for tuberculosis treatment: a meta-analysis of randomized controlled trials

Moxifloxacin is an effective and safe candidate agent for tuberculosis treatment: a meta-analysis

The Effectiveness and Safety of Fluoroquinolone-Containing Regimen as a First-Line Treatment for Drug-Sensitive Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis

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