5.2.3 Choice of fluoroquinolone

In terms of choice of fluoroquinolone, either levofloxacin or moxifloxacin may be used in the 9-month all-oral regimen, because they have shown similar efficacy for treating MDR/RR-TB. Although levofloxacin results in a higher pill burden, it is often preferred because moxifloxacin is associated with a higher risk of QT interval prolongation (49). Clinically significant, severe QT interval prolongation is relatively uncommon among patients treated with the 9-month all-oral regimens. However, the additive effect of co-administration of other QT-prolonging drugs (i.e. bedaquiline and clofazimine) within the shorter regimen should be considered when deciding on an appropriate regimen for individual patients with other risk factors for cardiotoxicity.

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