Tuberculosis treatment requires a combination of several drugs to be administered. Fluoroquinolones are sometimes included in the therapy. The researchers have demonstrated that moxifloxacin outperforms two other commonly used fluoroquinolones, using computer simulations. The study has been published in PLOS Computational Biology.
Millions are affected by tuberculosis each year. This increases the need for adequate treatment which needs to be administered for 6 months. One among three fluoroquinolones is commonly used in this treatment, which includes moxifloxacin, levofloxacin, or gatifloxacin. However, the existing data from clinical trials and animal studies are inadequate to conclude the best drug, or to determine if all three are equally potent.
Elsje Pienaar and a team at the University of Michigan in Ann Arbor and Rutgers developed a computer model which stimulated the effects of the three drugs on granulomas (clusters of host cells and bacteria) that form in the lungs of patients infected with the tubercle bacillus. Experimental data on the three drugs and their chemical activity were included in the computer model.
In the study, the researchers simulate treatment using the computer model. Each of the three drugs was simulated and compared on the basis of several criteria. The reports were based on the efficiency to kill bacteria in granulomas. The research team found moxifloxacin to be superior to both levofloxacin and gatifloxacin. It cleared bacteria in the granulomas more rapidly and also outperformed the other drugs when the patients missed doses. Levofloxacin could clear bacteria faster than gatifloxacin. On other hands, all drugs in the study were unsuccessful in killing bacteria at the core of granulomas.
Pienaar highlighted, "The exciting thing about this study is that we are able perform a side-by-side comparison of fluoroquinolones in identical infections." The significant application of their study is that they provide a guide to the selection of individual fluoroquinolones for tuberculosis treatment.
The predictions of the simulations are now being tested using animal models. Moxifloxacin and other fluoroquinolones are also being tested alongside other tuberculosis drugs to determine their combined efficacy using the computer simulations, to narrow down the best possible drug combinations for tuberculosis treatment.