Moxifloxacin: An Alternative to Ethambutol for the Treatment of Presumed Ocular Tuberculosis

Abstract

Objective: To present moxifloxacin as an alternative treatment option to ethambutol in an anti-tubercular therapy (ATT) regime in patients with presumed ocular tuberculosis (TB).

Methods: We identified all cases in our hospital referred for treatment of presumed ocular TB between 2009 and 2013. Age, gender, ophthalmic examination, blood tests, treatment regimens, adverse drug reactions, and outcomes were collected and analyzed for the patients who had moxifloxacin as part of their ATT.

Results: Forty-three cases of presumed ocular TB were treated with moxifloxacin as a part of ATT. Mean age was 44.18 ± 12.47 years; 62.8% were male. A response to treatment, with no evidence of disease recurrence, was seen in 72.1% of cases. Shortened ATT duration was associated with increased risk of treatment failure (p = 0.02, 95% CI: −0.77 to −0.00).

Conclusions: Moxifloxacin can be considered as a safe and effective alternative to ethambutol for the treatment of presumed ocular TB.

Keywords:

• Anti-tubercular therapy (ATT)
• drug-resistant TB
• duration of ATT
• ethambutol
• moxifloxacin
• presumed ocular tuberculosis

Author contributions

JP and RA jointly wrote the first draft of the manuscript and were involved in critical input and data analysis and interpretation. RA edited the first draft of the manuscript and was involved in study design, data collection, analysis, and intellectual input. FR and CB provided vital advice and significant contribution to data collection. CP, VW, and MW were directly involved in patient care and edited the draft and provided intellectual input for the study design and data collection.

RA was on an NMRC overseas research training fellowship at Institute of Ophthalmology and Moorfields Eye Hospital, London.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Funding

This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.