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Moxifloxacin: a potential new drug for shortening treatment of pulmonary TB?

Stephen H Gillespie

TB requires treatment for at least 6 months with the standard regimen utilizing isoniazid, rifampicin, ethambutol and pyrazinamide. There is a pressing need for shorter regimens to improve adherence and completion rates. Moxifloxacin is highly active in vitro against Mycobacterium tuberculosis, is well absorbed with a wide volume of distribution. The drug is concentrated in lung tissue and in macrophages: important target sites for TB treatment. The excellent bactericidal activity data has been confirmed in animal models and Phase II studies. Animal experiments suggest that by using moxifloxacin to replace either ethambutol or isoniazid in the regimen, the duration of TB treatment could be shortened. This review summarizes the data that support the development of this drug into new treatment regimens.