Moxifloxacin is a safe and effective candidate agent for tuberculosis treatment: a meta-analysis of randomized controlled trials.

Abstract

BACKGROUND\nMoxifloxacin is a fourth-generation fluoroquinolone that has shown good antibacterial activity against both gram-positive cocci and gram-negative bacteria. The purpose of this study was to evaluate the safety and efficacy of moxifloxacin in the drug treatment regimen of patients with tuberculosis.\n\n\nMETHODS\nWe conducted an electronic database search of the PubMed, Embase, the Cochrane Controlled Center Register of Controlled Trials (CENTRAL), Web of Science, Baidu Scholar, and Google Scholar for literature related to clinical randomized controlled trials (RCTs) of tuberculosis patients (from the date of inception of the database to September 25, 2020). The experimental group received moxifloxacin while the control group did not use moxifloxacin. After literature screening, data extraction, and literature quality evaluation, the included studies were meta-analyzed using RevMan software 5.1.\n\n\nRESULTS\nIn total, 13 RCTs involving 7,774 patients were included in this meta-analysis. The negative rate of sputum culture in the experimental group (which received moxifloxacin) was significantly higher than that of the control group after 2 months of treatment [relative risk (RR) =1.12, 95% confidence interval (CI): 1.06-1.18, P<0.0001]. Treatment-related complications in the experimental group were significantly greater than those in the control group (RR =1.34, 95% CI: 1.07-1.67, P=0.01). There was no significant difference in the incidence of serious complications between the two groups (RR =1.09, 95% CI: 0.90-1.33, P=0.38). In addition, there were no significant differences in mortality and recurrence rate between the two groups (RR =0.79, 95% CI: 0.51-1.21, P=0.28; RR =1.41, 95% CI: 0.61-3.25, P=0.42).\n\n\nCONCLUSIONS\nThis meta-analysis found that the addition of moxifloxacin to the treatment regimen of pulmonary tuberculosis patients could significantly increase the negative rate of sputum culture after treatment; however, it has no significant effect on the recurrence rate. Also, the addition of moxifloxacin was found to increase the incidence of complications, but did not increase the incidence of mortality or serious complications.