Therapeutic Effects Of Containing Mocifloxacin Or Levofloxacin Regimens On Multidrug Resistant Pulmonary Tuberculosis

Objective:Multidrug resistant tuberculosis (MDR-TB) is defined as resistance to at least the first-line drugs isoniazid and rifampin. The World Health Organization (WHO) reported that among new cases of tuberculosis, an estimated 5 percent, or 500,000 annually, are multidrug resistant (MDR). MDR-TB consists chiefly of Multidrug resistant pulmonary tuberculosis (MDR-PTB).And MDR-PTB is the causes of widespread Multidrug resistant Mycobacterium tuberculosis (MDR-MTB). With the develope of research, fluoroquinolone antimicrobial is proved have no cross resistant to other anti-tuberculosis drugs. WHO recommend fluoroquinolone to cure MDR-TB.WHO suggested to use Ofloxacin and Ciprofloxacin to cure MDR-TB in 1996.In 2003 Chinese Anti-tuberculosis Organization recommend Levofloxacin to cure MDR-TB.Fluoroquinolone become the chief drug to cure MDR-PTB. Moxifloxacin is one of the newly applied antibiotics fourth belonging to the forth generation of fluoroquinolone drugs. It has fine therapeutic effects to some common drug resistant Mycobacterium. To find the efficient and safe chemotherapy to MDT-PTB, we observe Moxifloxacin to cure MDR-PTB from January 2007 to December 2008, and compare with Levofloxacin.To assess the efficacy and safety of moxifloxacin in the treatment of MDR-PTB.Methods:Between January 2007 to December 2008,82 cases of MDR-PTB were randomized into two group. In treatment group, moxifloxacin, pasiniazid, rifapentine, pyrazinamide, protimonamide, amikacin and para-aminosalicylic acid were administrated in the initial 3-month phase. In the following 6-month phase, moxifloxacin, pasiniazid,rifapentine,pyrazinamide and protimonamide were used. And then in the 9 months continuation phase, patients received moxifloxacin, pasiniazid, rifapentine,pyrazinamide.Drug administration in control group was similar to treatment group, the only exception was that moxifloxacin was replaced by levofloxacin.Results:There are 35 cases in the treatment group complete course and 30cases in the control group complete course.After complete the treatment course, the sputum negative conversion rate of above two groups was 82.9% and 60% respectively. The rate of radiological evident improvement was 91.4% and 80%.The rate of cavity closure was 65.8% and 37.5%.Conclusion:Fluoroquinolone become the chief drug to cure MDR-PTB. Fluoroquinolone has been commonly used in the clinical treatment. The therapeutic effects of contain fluoroquinolone regimens to cure MDR-TB is better than that of contain none fluoroquinolone regimens. In the treatment of multidrug resistant pulmonary tuberculosis, the efficacy and safety of moxifloxacin are superior to Levofloxacin.it is recommending to use MXFX to cure MDR-PTB.