MDR-TB Treatment & Prevention

Hi Askar,

Sparfloxacin was removed from the U.S. market because of QT-interval prolongation and increased risk of heart arrhythmias. So, I think it's not a good idea to use it if you have another choice.

If using moxifloxacin is a problem, you might consider using high-dose levoquin (750 mg for people weighing less than 50 kg; 1000 mg for people weighing more than 50 kg). This is the dosing that the Iseman's group in Denver uses.

I'm attaching a paper by John Johnson at Case Western University who shows in EBA studies that it might actually be more effective than Moxi as far as early bactericidal activity.

We just had a clinical trials meeting in Cambridge and the Johns Hopkins group showed studies in mice where high dose Levo was as effective as Moxi. It is interesting because people thought Moxi was better because of the molecule; now it seems that its effectiveness might be linked to the high blood levels. Maybe that is why high-dose levo works well: it also reaches high blood levels.

Lastly, the GLC has stopped recommending OFL as it's first line anti-TB FQ and is moving toward suggesting Levo for ...

Hi Askar,

Sparfloxacin was removed from the U.S. market because of QT-interval prolongation and increased risk of heart arrhythmias. So, I think it's not a good idea to use it if you have another choice.

If using moxifloxacin is a problem, you might consider using high-dose levoquin (750 mg for people weighing less than 50 kg; 1000 mg for people weighing more than 50 kg). This is the dosing that the Iseman's group in Denver uses.

I'm attaching a paper by John Johnson at Case Western University who shows in EBA studies that it might actually be more effective than Moxi as far as early bactericidal activity.

We just had a clinical trials meeting in Cambridge and the Johns Hopkins group showed studies in mice where high dose Levo was as effective as Moxi. It is interesting because people thought Moxi was better because of the molecule; now it seems that its effectiveness might be linked to the high blood levels. Maybe that is why high-dose levo works well: it also reaches high blood levels.

Lastly, the GLC has stopped recommending OFL as it's first line anti-TB FQ and is moving toward suggesting Levo for everybody. Moxi is especially beneficial for pts with renal failure since it is not renally cleared (while levo is).

I hope that this helps.