A four-month Gatifloxacin-containing regimen for treating tuberculosis

Shortened antituberculosis treatment regimens are expected to improve patient adherence to treatment, thus favoring better case management and disease control and minimizing the risk of drug resistance.1-3 The first indication that fluoroquinolones had the potential to shorten tuberculosis treatment was from an observational study in India4 in which ethambutol was replaced with ofloxacin. The fourth-generation fluoroquinolones gatifloxacin and moxifloxacin have shown mycobactericidal activity that is better than that of ofloxacin in vitro5 and in vivo,6-9 and these agents have the potential to shorten treatment. Gatifloxacin was chosen for this study on the basis of its bactericidal-activity profile, cost, and generic status. We conducted a phase 3 trial that evaluated the efficacy and safety of a 4-month gatifloxacin-containing regimen, as compared with a standard 6-month regimen, for the treatment of rifampin-sensitive pulmonary tuberculosis.