Randomized Controlled Trial of a Drug Regimen That Includes Ciproftoxacin for the Treatment of Pulmonary Tuberculosis

Abstract

The fluoroquinolones are promising new antituberculous agents. A randomized controlled trial of 200 adult patients with sputum smear-positive pulmonary tuberculosis was conducted in Tanzania. Patients received either a trial regimen (HRC) consisting of isoniazid (300 mg), rifampin (600 mg), and ciprofloxacin (750 mg) or a control regimen (HRZE) consisting of isoniazid (300 mg), rifampin (600 mg), pyrazinamide (25 mg/kg), and ethambutol (15 mg/kg). The 168 evaluable patients all had negative smears and cultures by month 6, but the time to conversion to negativity was longer for the HRC group than for the HRZE group because of the poor response of patients infected with human immunodeficiency virus (HIV) to the HRC regimen. Relapse was more frequent in the HRC group. The sterilizing activity of ciprofloxacin does not appear to be equal to that of the combination of pyrazinamide and ethambutol, but the difference in outcome was significant only among HIV-infected patients.

Treatment Outcomes of Patients with HIV and Tuberculosis

“…In general, treatment outcomes of conventional 6-month, rifamycin-based regimens for tuberculosis are reported as being equivalent in HIV-infected and HIV-uninfected individuals (7)(8)(9)(10)(11)(12). As a consequence, current guidelines recommend a 6-month, rifamycin-based course for all patients with drugsusceptible tuberculosis regardless of their HIV serostatus (2).…”

Acute liver failure due to antitubercular therapy: Strategy for antitubercular treatment before and after liver transplantation

“…7,8 Guidelines about the treatment of these patients exist in the literature, and they include information about the time to initiate ATT after ALF, the decision to reintroduce or not reintroduce standard ATT (with potentially hepatotoxic drugs), and the effectiveness of alternative nonhepatotoxic anti-TB drugs such as ofloxacin (OFX), ciprofloxacin (CFX), moxifloxacin (MOX), and amikacin (AMK). [9][10][11][12][13][14][15][16][17] These drugs have been shown to be effective and safe in patients with strains resistant to multiple drugs, but their use in patients with ALF before or after LT remains limited.…”

Intermittent Versus Daily Pulmonary Tuberculosis Treatment Regimens: A Meta-Analysis

“…18,24,[41][42][43] Pooled Results Primary outcome -same intensity of dosing throughout Intermittent regimens: Rifampicin was administered intermittently (I/I) in both phases (twice to thrice weekly) in nine datasets; all of these datasets had a CP of 4 months. 23,24,26,28,30,44 The overall treatment success with this intermittent regimen was 88% (95% CI, 81-92), failure and relapse rates were 5% (95% CI, 2-9) versus 7% (95% CI, 3-11), and default rate was 0% (95% CI, 0-2) (table 1).…”

“…Moreover, in one study, a third of the 1,240 patients included were previously treated. 23 In all these scenarios, ineligible patients could not be excluded by both regimen type and treatment outcome. Again, instead of rifampicin (R), rifabutin was used in two of the studies included with a total of 491 participants.…”

“…Again, instead of rifampicin (R), rifabutin was used in two of the studies included with a total of 491 participants. 24,25 Treatment doses were fully supervised in eleven studies, [19][20][21]23,[26][27][28][29][30][31][32] supervised as well as self-administered in nine studies, 22,25,[33][34][35][36][37][38] and only self-administered in two, 39,40 while treatment modality was unspecified in five studies. 18,24,[41][42][43] Pooled Results Primary outcome -same intensity of dosing throughout Intermittent regimens: Rifampicin was administered intermittently (I/I) in both phases (twice to thrice weekly) in nine datasets; all of these datasets had a CP of 4 months.…”