The Bactericidal Activity of Moxifloxacin in Patients with Pulmonary Tuberculosis

• Published in: American journal of respiratory and critical care medicine Vol. 168; no. 11; pp. 1342 - 1345
• Main Authors: Gosling, Roly D, Uiso, Leonard O, Sam, Noel E, Bongard, Emily, Kanduma, Esther G, Nyindo, Mramba, Morris, Richard W, Gillespie, Stephen H
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 01.12.2003; American Lung Association; American Thoracic Society
• Subjects: Adolescent; Adult; Aged; Antibacterial agents; Antibiotics, Antitubercular - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Aza Compounds - administration & dosage; Biological and medical sciences; Female; Fluoroquinolones; Humans; Inhibitory Concentration 50; Isoniazid - administration & dosage; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Mycobacterium tuberculosis - drug effects; Pharmacology. Drug treatments; Quinolines - administration & dosage; Rifampin - administration & dosage; Sputum - microbiology; Tuberculosis, Pulmonary - drug therapy; Tuberculosis, Pulmonary - microbiology; Human; Lung disease; Prognosis; Respiratory disease; Lung; Africa; Controlled therapeutic trial; Mycobacterial infection; Moxifloxacin; Infection; quinolone; Antibiotic; Chemotherapy; Fluoroquinolone derivatives; Treatment; Tuberculosis; Follow up study; Bacteriosis; clinical trials; Quinolone derivatives
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.200305-682OC

Patients in whom acid-fast bacilli smear-positive pulmonary tuberculosis was newly diagnosed were randomized to receive 400 mg moxifloxacin, 300 mg isonaizid, or 600 mg rifampin daily for 5 days. Sixteen-hour overnight sputa collections were made for the 2 days before and for 5 days of monotherapy. Bactericidal activity was estimated by the time taken to kill 50% of viable bacilli (vt50) and the fall in sputum viable count during the first 2 days designated as the early bactericidal activity (EBA). The mean vt50 of moxifloxacin was 0.88 days (95% confidence interval [CI], 0.43-1.33 days) and the mean EBA was 0.53 (95% CI 0.28-0.79). For the isoniazid group, the mean vt50 was 0.46 days (95% CI, 0.31-0.61 days) and the mean EBA was 0.77 (95% CI, 0.54-1.00). For rifampin, the mean vt50 was 0.71 days (95% CI, 0.48-0.95 days) and the mean EBA was 0.28 (95% CI, 0.15-0.41). Using the EBA method, isoniazid was significantly more active than rifampin (p < 0.01) but not moxifloxacin. Using the vt50 method, isoniazid was more active than both rifampin and moxifloxacin (p = 0.03). Moxifloxacin has an activity similar to rifampin in human subjects with pulmonary tuberculosis, suggesting that it should undergo further assessment as part of a short course regimen for the treatment of drug-susceptible tuberculosis.