Abstract

In response to Gyanshankar Mishra, we used the best available published data to place the fluoroquinolones ahead of the injectables in our priority listing, because the former have been associated with better treatment outcomes in most studies of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. Furthermore, high-dose levofloxacin (1000 mg per day) has a better pharmacological profile than does normal-dose moxifloxacin. First, we agree that the scant information, necessitates further clinicopharmacological studies, which should not only compare high-dose levofloxacin with normal-dose moxifloxacin, but also make a comparison with high dose moxifloxacin in view of the 2010 study by Van Deun and colleagues in Bangladesh, in which a cure rate of 87·9% was achieved with a 9 month regimen including gatifloxacin at a high dose (800 mg per day).

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