Comparison of levofloxacin versus moxifloxacin for multidrug-resistant tuberculosis

Am J Respir Crit Care Med. 2013 Oct 1;188(7):858-64. doi: 10.1164/rccm.201303-0604OC.


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. Clinical trial registered with (NCT 01055145).

Trial registration: NCT01055145.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use
  • Aza Compounds / administration & dosage
  • Aza Compounds / pharmacology
  • Aza Compounds / therapeutic use*
  • Fluoroquinolones
  • Humans
  • Levofloxacin / administration & dosage
  • Levofloxacin / pharmacology
  • Levofloxacin / therapeutic use*
  • Middle Aged
  • Moxifloxacin
  • Prospective Studies
  • Quinolines / administration & dosage
  • Quinolines / pharmacology
  • Quinolines / therapeutic use*
  • Republic of Korea
  • Sputum / drug effects
  • Sputum / microbiology
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Pulmonary / drug therapy*
  • Young Adult


  • Antitubercular Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Levofloxacin
  • Moxifloxacin

Associated data