Efficacy of the ultra-short-course chemotherapy regimen containing moxifloxacin and pyrazinamide for primary smear positive pulmonary tuberculosis

Abstract

Objective To investigate the clinical effect of moxifloxacin and pyrazinamide-containing ultra-short chemotherapy in the treatment of primary smear positive pulmonary tuberculosis. Methods A total of 120 patients with primary smear positive pulmonary tuberculosis were selected in Hangzhou Red Cross Hospital from September 2014 to December 2017. These patients were randomly divided into two groups with 60 cases in each group. The control group was treated with 2-month regimens of isoniazide, rifampin, ethambutol and pyrazinamide, followed by 4-month regimens of isoniazide, rifampin and ethambutol. The observation group was treated with 4-month regimens of moxifloxacin, rifampin, ethambutol and pyrazinamide. The sputum conversion rate after the 2-month treatment, the focus absorption rate and the cavity closure rate after the whole treatment, the relapse rate, scores of life quality, immune function index and adverse reaction 1 year after treatment completed were compared between the two groups. Results The full and significant absorption rate of focus, sputum negative conversion rate and cavity closure rate in observation group after the treatment were significantly higher than those in control group (90.00% vs 75.00%, 85.00% vs 72.00%, 81.67% vs 60.00%, χ2=4.675, 3.871 and 6.817, P all <0.05) . After the treatment, the scores of quality of life including physical health, mental health, material life and social function in the observation group were 89.47±8.69, 84.49±8.21, 88.16±9.24, 85.46±8.95, respectively, which were all higher than those in control group (t=5.853, 5.308, 5.458 and 6.207, P all <0.01) . The indexes of CD3+, CD4+/CD8+ and NK in the observation group after the treatment were (44.15±6.39) %, 1.04±0.27 and (31.26±3.29) %, which were significantly higher than those in control group (t=6.339, 5.276 and 4.754, P all <0.01) . There was no significant difference in the incidence rates of adverse reactions such as gastro-intestinal response, drug induced liver injury, rash and leucopenia between two groups. No relapse happened in two groups. Conclusions The ultra-short-course chemotherapy regimen containing moxifloxacin and pyrazinamide can effectively promote focus absorption, sputum negative conversion, pulmonary cavity closure in patients with primary smear positive pulmonary tuberculosis. The regimen is safe and reliable. Key words: Tuberculosis, pulmonary; Moxifloxacin; Pyrazinemide; Cavity closure rate; Quality of life