An Overview on Fluoroquinolone Drugs for the Treatment of Tubercular Infection

Asif, Mohammad

doi:10.15406/ijbsbe.2017.02.00012

Cited by 2 publications

(2 citation statements)

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“…Moxifloxacin and Levofloxacin are the two most potent fluoroquinolones (FQs) currently in use as a core MDR-TB treatment regimens. 9,10 In terms of in-vitro drug susceptibility, moxifloxacin is more potent (critical concentration 0.25 mcg/L) than levofloxacin (critical concentration, 0.5 mcg/mL). 11 Although these drugs have good safety record in long-term administration, their potential to prolong the QT interval (which is more pronounced with moxifloxacin) has raised a concern.…”

Section: Introductionmentioning

confidence: 99%

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Sidamo¹,

Shibeshi²,

Yimer³

et al. 2021

IDR

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Purpose/Background: Although Ethiopia is among the thirty high multi-drug resistant tuberculosis (MDR-TB) burden countries in the world, comparative therapeutic efficacy of moxifloxacin and levofloxacin has not been explored, particularly in MDR-TB patients. We therefore aimed to prospectively compare clinical outcomes and determine potential predictors of the outcomes among patients on moxifloxacin or levofloxacin-based MDR-TB drug regimens. Methods: We analyzed clinical parameters and laboratory data of eighty MDR-TB patients on moxifloxacin-or levofloxacin-based regimens. The clinical outcomes were compared using the Kaplan-Meier survival functions and the outcome definitions of the 2013 World Health Organization. Monthly sputum culture conversions and a molecular line probe assay results were also assessed. Observed outcomes and patient-related variables between the two groups were compared using chi-square, Wilcoxon Rank and Fisher exact tests. We also determined the potential predictors influencing treatment outcomes of moxifloxacin and levofloxacin using Cox proportional hazard model. Results:The levofloxacin-based treatment group had a lower failure rate and adverse drug events as well as better treatment success than the moxifloxacin-based group. Overall treatment success was 65%. Disaggregating the data revealed that 53.8% were cured, 11.2% completed treatment, 10.0% died, 11.2% failed, and 13.8% were lost-to-follow-up. The line probe assay result showed that 11.3% of the clinical isolates were resistant to fluoroquinolones and 3.8% were resistant to both fluoroquinolones and injectable anti-TB agents. Treatment regimen type, culture conversion rate, alcohol use, cavity lesion, serum levels of creatinine and alanine aminotransferase were independent predictors of treatment outcome. Conclusion:The levofloxacin-based regimen group has a better overall treatment success than the moxifloxacin-based group among MDR-TB patients. Clinical parameters and substance use history of the patients influenced treatment outcomes. We recommend further broader clinical studies to substantiate our findings as an input to review MDR-TB treatment guidelines.

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Section: Introductionmentioning

confidence: 99%

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Sidamo¹,

Shibeshi²,

Yimer³

et al. 2021

IDR

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“…Fluoroquinolones are known to prolong the QT interval, which may increase the risk of severe heart rhythm disturbances, more common in Mfx administration, especially if bedaquiline and clofazimine are associated. Cardiac monitoring is recommended when drugs that prolong the QT interval are used [27].…”

Section: Group a Fluoroquinolones(q)mentioning

confidence: 99%

Antibiotic Resistance of Mycobacterium Tuberculosis; Mechanisms and Specific Therapeutic Response

Popescu¹

2020

FARMACIA

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Although epidemiologic indicators of tuberculosis (TB) are rapidly improving in Romania, the disease remains a high priority of the public health. In the last years, the World Health Organization (WHO) has paid particular attention to the phenomenon of multidrug resistant tuberculosis (MDR-TB), which Romania is not exempt from. As an endemic, TB has a long history. In the evolution of this disease, the etiological treatment had a later appearance, but the drug resistance phenomenon, acting as selection pressor, was highlighted from the beginning. The advanced knowledge of the drug resistance mechanisms, early imposed the idea of drug combination. The history of the development and use of chemotherapeutic agents in the treatment of TB demonstrates the difficulty in obtaining strong resilience of the therapeutic regimens and the increased risk of unsuccessful outcomes, due to the drug resistance phenomenon. Expanding the global response to MDR-TB is relatively recent, only the last two decades, but the progress has been substantial. The latest WHO guidelines for MDR-TB therapy is a "game-changer". This article updates the new classification of anti-TB drugs by classes, their characteristics and place in the therapeutic regimes, but also the recommendations and challenges for their application. RezumatDeși indicatorii epidemiologici ai tuberculozei se îmbunătățesc rapid în România, tuberculoza rămâne o problemă prioritară de sănătate publică. În ultimii ani, Organizația Mondială a Sănătății (OMS) acordă o atenţie deosebită tuberculozei multidrog rezistente (TB-MDR), de la care nici România nu este exceptată. Ca endemie, tuberculoza are o evoluție lungă. Tratamentul etiologic a apărut târziu în istoria acestei maladii, însă fenomenul rezistenței la antibiotice, care funcționează ca presor de selecție, a fost pus în evidență încă de la început. Înțelegerea mai aprofundată a mecanismelor apariției a chimiorezistenței a impus încă de timpuriu ideea terapiei asociate. Istoria descoperirii și utilizării chimioterapicelor în tratamentul TB-MDR demonstrează cât este de dificilă stabilizarea regimurilor terapeutice și cât de periculoasă pentru controlul bolii este emergența multirezistenței. Dezvoltarea răspunsului global la problemă este de dată relativ recentă, circa două decenii, dar progresele sunt substanțiale. Ultimele ghiduri ale OMS dedicate terapiei TB-MDR, sunt un "game-changer". Articolul prezintă noua clasificare a medicamentelor antituberculoase, caracteristicile și poziția lor în schemele terapeutice, precum și recomandări și provocări ale administrării lor.

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An Overview on Fluoroquinolone Drugs for the Treatment of Tubercular Infection

Cited by 2 publications

References 47 publications

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Explorative Analysis of Treatment Outcomes of Levofloxacin- and Moxifloxacin-Based Regimens and Outcome Predictors in Ethiopian MDR-TB Patients: A Prospective Observational Cohort Study

Antibiotic Resistance of Mycobacterium Tuberculosis; Mechanisms and Specific Therapeutic Response

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