Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2011 Jun;26(2):153-9. doi: 10.3904/kjim.2011.26.2.153. Epub 2011 Jun 1.
BACKGROUND/AIMS: To compare the effect of levofloxacin and moxifloxacin on treatment outcomes among patients with multidrug-resistant tuberculosis (MDR-TB).
A retrospective analysis of 171 patients with MDR-TB receiving either levofloxacin or moxifloxacin was performed. Treatment responses were categorized into treatment success (cured and treatment completed) or adverse treatment outcome (death, failure, and relapsed).
The median age of the patients was 42.0 years. Approximately 56% of the patients were male. Seventeen patients had extensively drug-resistant tuberculosis, and 20 had a surgical resection. A total of 123 patients (71.9%) received levofloxacin for a median 594 days, and 48 patients (28.1%) received moxifloxacin for a median 673 days. Other baseline demographic, clinical, and radiographic characteristics were similar between the two groups. The moxifloxacin group had a significantly higher number of resistant drugs (p < 0.001) and a higher incidence of resistance to ofloxacin (p = 0.005) in the drug sensitivity test. The treatment success rate was 78.9% in the levofloxacin group and 83.3% in the moxifloxacin group (p = 0.42). Adverse reactions occurred at similar rates in the groups (p = 0.44). Patients in the moxifloxacin group were not more likely to have treatment success than those in the levofloxacin group (adjusted odds ratio, 0.76; 95% confidence interval, 0.24 to 2.43; p = 0.65).
Both levofloxacin and moxifloxacin showed equivalent efficacy for treating MDR-TB.
背景/目的：比较左氧氟沙星和莫西沙星对耐多药结核病（MDR-TB）患者治疗效果的影响。
对 171 例接受左氧氟沙星或莫西沙星治疗的 MDR-TB 患者进行回顾性分析。将治疗反应分为治疗成功（治愈和治疗完成）或不良治疗结局（死亡、失败和复发）。
患者的中位年龄为 42.0 岁。约 56%的患者为男性。17 例患者患有广泛耐药性结核病，20 例患者进行了手术切除。123 例（71.9%）患者接受左氧氟沙星治疗，中位疗程为 594 天，48 例（28.1%）患者接受莫西沙星治疗，中位疗程为 673 天。两组患者的其他基线人口统计学、临床和影像学特征相似。莫西沙星组药物敏感性试验中耐药药物数量明显较多（p < 0.001），氧氟沙星耐药发生率较高（p = 0.005）。左氧氟沙星组的治疗成功率为 78.9%，莫西沙星组为 83.3%（p = 0.42）。两组不良反应发生率相似（p = 0.44）。莫西沙星组患者的治疗成功率并不高于左氧氟沙星组（调整后的优势比为 0.76；95%置信区间为 0.24 至 2.43；p = 0.65）。
左氧氟沙星和莫西沙星治疗 MDR-TB 的疗效相当。
