Comparison of the efficacy of moxifloxacin and ethambutol in the treatment of pulmonary tuberculosis

According to preclinical studies, moxifloxacin has promising activity against Mycobacterium tuberculosis, but this effect has not been evaluated using multicomponent therapy in humans.

American scientists compared the activity of moxifloxacin to ethambutol, and the two drugs compared were used in combination with isoniazid, rifampicin and pyrazinamide. The study involved 336 adult patients with Mycobacterium tuberculosis sputum. Patients were randomized into 2 groups: the first group received 400 mg of moxifloxacin 5 days a week, the second - ethambutol 3 days a week after daily administration of the drug for two weeks. The main measure of effectiveness was the presence of mycobacteria in a sputum sample after two months of treatment.

Of the 336 patients enrolled in the study, 277 (82%) were eligible for performance evaluation. More than half of the patients (67%) were men, 206 patients (74%) had radiological signs of pulmonary tuberculosis and 60 people (22%) had HIV infection.

After 2 months of treatment, the bacteriological results of sputum were negative in 71% of patients (99 out of 139) who received moxifloxacin and 71% (98 out of 138) who received ethambutol (p = 0.97 ). However, in people receiving moxifloxacin, sputum culture tests were more often negative after 4 weeks of treatment. In addition, nausea was more frequently observed in patients receiving moxifloxacin (22% vs 9% in patients receiving ethambutol, p = 0.002); at the same time, the proportion of patients completing the treatments planned in the study groups was comparable (88% vs 89%, respectively).

Thus, complex therapy for pulmonary tuberculosis, including moxifloxacin in combination with isoniazid, rifampicin, and pyrazinamide, is no more effective in evaluating eradication of the sputum pathogen compared to therapy using ethambutol in combination with the above drugs, but gives better results earlier in therapy terms.