The Efficacy And Safety Of Different Quinolones In The Treatment Of Drug-resistant Pulmonary Tuberculosis:a Meta-analysis

Objective To systematically review the difference of efficacy and safety between Moxifloxacin and Levofloxacin in the treatment of drug-resistant pulmonary tuberculosis(Safety:adverse drug reaction; Effectiveness:clinical efficacy, sputum smear negative conversion rate, CT or X-ray lesions absorption rate, CT or X-ray of void closure).Methods Searching CNKI, WANFAN, MED ONLINE, Med Line, Pub Med, Elsevier databases from January of 2005 to December of 2015 to identify all RCTs and compared the efficacy and safety of Moxifloxacin to systemic treat of Levofloxacin in the patients with drug-resistant pulmonary tuberculosis. Researching on the keyword through to meet the requirements of the literature preliminary reading, including reading the literature title,abstract. After reading the first elected with a screening of standard literature.Download Text with standard of literature research, comprehensive reading. According to the exclusion criteria:(1) the object of study of the non randomized controlled trials;(2)no original data in literature. Inclusion criteria:(1) research object- a randomized controlled clinical trial.(2)the research content for moxifloxacin, left ofloxacin in the treatment of drug-resistant pulmonary tuberculosis the clinical efficacy and safety of analysis;(3) the research object of the route of administration were for oral administration;(4)the same dose of moxifloxacin and Levofloxacin;(5) research outcome for the overall efficacy of treatment, the sputum negative conversion rate, cavity closure rate, focus absorption rate and drug adverse reaction. Finally, the literatures were screened out, and the quality of the articles was scored by the jadad scale. Collating the relevant data included in the literature,using of Rev Men5.1 software for all data meta analysis. Study outcomes were two classification variables, so using OR(odds ratio)effect quantity. The95% confidence interval of OR(CI)said the results of the included studies and data heterogeneity test. The software system to generate forest graph representation of the results of the meta-analysis, funnel graphics software system to generate that included in the literature the existence.Results Fourteen clinical trails with a total of 1172 patients were included in the meta-analysis.And all patients were diagnosed with drug-resistant pulmonary tuberculosis. Meta-analysis showed that there was no difference between MXF and LFX on the adverse drug reaction.However, the result of the clinical effective rate, lesion effective absorption rate,the void closure and the smear-negative rate of smear-positive,Moxifloxacin is better than Levofloxacin.The analysis results are as follows:the effective of MXF versus LFX on the clinical effective rate(OR=3.91, 95%CI 2.54-6.52); the effective of MXF versus LFX on the lesion effective absorption rate(OR=2.11, 95%CI1.40-3.17); the effective of MXF versus LFX on the void closure rate(OR=2.07, 95%CI1.38-3.10); the effective of MXF versus LFX on the smear-negative rate of smear-positiveon(OR=3.58, 95%CI 2.40-5.35); the effective of MXF versus LFX on the adverse drug reaction(OR=0.74, 95%CI 0.54-1.01).Conclusion The Moxifloxacin is better than Levofloxacin in the treatment of drug-resistance tuberculosis. Including the clinical effective rate, lesion effective absorption rate, the void closure and the smear-negative rate.