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고원중
고원중 (Won-Jung Koh) 저자 이메일 보기
성균관의대, 삼성서울병원
조회 1554  인쇄하기 주소복사 트위터 공유 페이스북 공유 
Comparison of Levofloxacin versus Moxifloxacin for Multidrug-Resistant Tuberculosis

Won-Jung Koh1*, Seung Heon Lee2*, Young Ae Kang3, Chang-Hoon Lee4, Jae Chol Choi5, Jae Ho Lee6, Seung Hun Jang7, Kwang Ha Yoo8, Ki Hwan Jung2, Ki Uk Kim9, Sang Bong Choi10, Yon Ju Ryu11, Kyung Chan Kim12, Soojung Um13, Yong Soo Kwon14, Yee Hyung Kim15, Won-Il Choi16, Kyeongman Jeon1, Yong Il Hwang7, Se Joong Kim2, Young Seok Lee17, Eun Young Heo4, Juhee Lee18, Yeo Woon Ki19, Tae Sun Shim20, and Jae-Joon Yim19

1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
3Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
5Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Republic of Korea
6Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
7Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do, Republic of Korea
8Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea
9Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea
10Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
11Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Medical Center and Ewha Medical Research Institute, Ewha Womans University School of Medicine, Mokdong Hospital, Seoul, Republic of Korea
12Department of Internal Medicine, Catholic University of Daegu Hospital, Daegu, Republic of Korea
13Department of Internal Medicine, Division of Respirology, Dong-A University Medical Center, Busan, Republic of Korea
14Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
15Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
16Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
17Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital Inje University College of Medicine, Busan, Republic of Korea
18Medical Research Collaborating Center and
19Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea; and
20Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

Abstract
Rationale: Levofloxacin (LFX) and moxifloxacin (MXF) are the two most frequently recommended fluoroquinolones for treatment of patients with multidrug-resistant tuberculosis (MDR-TB). However, studies comparing the effectiveness of LFX and MXF among patients with MDR-TB are lacking.

Objectives: To compare the effectiveness of LFX and MXF in terms of culture conversion after 3 months of treatment for MDR-TB.

Methods: In this prospective multicenter randomized open label trial, we randomly assigned 182 patients with MDR-TB (sensitive to LFX and MXF) to receive either LFX (750 mg/day; 90 patients) or MXF (400 mg/day; 92 patients) with a background drug regimen. The primary outcome was the proportion of patients who achieved sputum culture conversion at 3 months of treatment. Secondary outcomes were time to culture conversion and time to smear conversion, with data censored at 3 months, and the proportions of adverse drug reactions.

Measurements and Main Results: At 3 months of treatment, 68 (88.3%) of the 77 patients in the LFX group and 67 (90.5%) of the 74 in the MXF group showed conversion to negative sputum cultures (odds ratio for LFX compared with MXF, 0.78; 95% confidence interval, 0.27-2.20). Adverse drug reactions were reported in six patients (7.7%) in the LFX group and four (5.2%) in the MXF group (P = 0.75).

Conclusions: The choice of LFX or MXF for treatment of patients with MDR-TB may not affect sputum culture conversion at 3 months of treatment.

KEYWORDS: multidrug-resistant tuberculosis, fluoroquinolone, moxifloxacin, levofloxacin

Correspondence and requests for reprints should be addressed to Jae-Joon Yim, M.D., Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
*W.-J.K. and S.H.L. contributed equally to this work.

논문정보
- 형식: Research article
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