Moxifloxacin Improves Treatment Outcomes in Patients with Ofloxacin-Resistant Multidrug-Resistant Tuberculosis

摘要: It is unclear whether the use of moxifloxacin (MFX), a newer synthetic fluoroquinolone, results in better outcomes patients with ofloxacin (OFX)-resistant multidrug-resistant tuberculosis (MDR-TB). During period from April 2006 to December 2013, total 2,511 culture-confirmed (TB) were treated at TB referral hospital southern Taiwan. Of patients, 325 (12.9%) had MDR-TB, and those 81 (24.9%) OFX-resistant MDR-TB included study. Among 50 (61.7%) successfully 31 (38.3%) unfavorable outcomes, including treatment failure (n = 25; 30.9%), loss follow-up 2; 2.5%), death 4; 4.9%). Patients MFX significantly higher rate success (77.3% versus 43.2%; odds ratio [OR] 4.46, 95% confidence interval [CI] 1.710 11.646, P 0.002) than not MFX, especially among infected MFX-susceptible isolates (40.7%) or low-level resistance (28.4%). Multivariate logistic regression analysis showed that (adjusted 6.54, CI 1.44 29.59, 0.015) was only independent factor associated success. Mutation codon 94 gyrA gene most frequent mutation (68.0%) high-level resistance. Cox proportional hazards also an early culture conversion (hazard 3.12, 1.48 0.003). Our show significant proportion susceptible indicating benefit MFX.