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JAC Advance Access published online on October 13, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki376
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Received June 24, 2005
Revised September 7, 2005
Accepted September 22, 2005

Brief report

Early bactericidal activity of a moxifloxacin and isoniazid combination in smear-positive pulmonary tuberculosis

Stephen H. Gillespie 1*, Roly D. Gosling 1, Leonard Uiso 2, Noel E. Sam 3, Esther G. Kanduma 3, and Timothy D. McHugh 1

1 Centre for Medical Microbiology, Hampstead Campus, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK
2 Kibong'oto National Tuberculosis Hospital, Sanya Juu, Tanzania
3 Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania

* To whom correspondence should be addressed.
Stephen H. Gillespie, E-mail: s.gillespie{at}medsch.ucl.ac.uk


  Abstract

Background: In vitro and animal studies have shown that moxifloxacin-containing combinations may improve the bactericidal efficacy of antituberculosis regimens.

Patients and methods: We measured the decline in the sputum viable count of 13 patients who were given a combination of moxifloxacin 400 mg daily and isoniazid 300 mg daily.

Results: The time required to reduce the viable count by 50% (vt50) was 0.38 days (95% CI -0.03-0.78 days, SEM 0.13) and the mean early bactericidal activity (EBA) was 0.60 log10 cfu/day (95% CI 0.23-0.97, SEM 0.14). This compares with the vt50 calculated for isoniazid and moxifloxacin alone in the same population of 0.48 and 0.88 days, respectively. The EBA values for isoniazid and moxifloxacin alone were 0.77 and 0.53 log10 cfu/day, respectively.

Conclusions: The combination of moxifloxacin and isoniazid is not antagonistic, but the combination does not significantly enhance bactericidal activity above that of isoniazid alone.

Keywords: Mycobacterium tuberculosis; clinical trials; drug effects; quinolones.
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