RT Journal Article
SR Electronic
T1 Adverse effects of moxifloxacin during tuberculosis treatment
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 4291
VO 40
IS Suppl 56
A1 Erik Schmok
A1 Graham Bothamley
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/4291.abstract
AB Aim: Prolonged use of moxifloxacin in tuberculosis (TB) may have adverse effects, particularly prolongation of the QT interval and arrhythmias.Methods: All TB patients treated with moxifloxacin from 2003-2011 were identified. Concurrent medication and history of drug abuse were noted. Charts noted adverse effects. ECGs were obtained on and off treatment and the longest QTc was used for the study.Results: 93 patients treated with moxifloxacin for at least one month were identified. Adverse effects included: nausea (2), palpitations (1) and photosensitivity (1); itching, arthralgia, flushing amd depression were probably due to concurrent medication. 60 patients had ECGs, mostly taken during treatment and none had a QTc >500 ms. Variability in QTc was high (standard deviation 31 ms). One male had a QTc > 450 and 3 females >470 ms but none had arrhythmias; one patient developed right bundle branch block during treatment, but this persisted when not taking moxifloxacin. All 4 used opiates.View this table:28 patients had paired ECGs on and off treatment showing a QTc interval increase of 6,4 msec (95 % CI -4,2 to 17,0 msec). Five increased by 69, 51, 48, 44 and 40 ms of whom four had limited access to opiates while in prison during their pre-treatment ECGs. Only one of the 28 had a QTc >450 ms after a normal interval (413 to 482 ms).Conclusions: Moxifloxacin is well tolerated in treating TB. ECGs should be performed at a standard time after ingestion and with concurrent urine drug screens.