Effects of Rifampicin Plus Levofloxacin or Isoniazid on Immune Function of Patients with Pulmonary Tuberculosis.

ABSTRACT

Context Due to the different effects of various drugs and the lack of authoritative and unified guidelines in clinical practice, the choice of therapeutic drugs for pulmonary tuberculosis (TB) remains controversial. Rifampicin, levofloxacin, and isoniazid are all anti-TB drugs. However, no comparative studies of the treatment effects of rifampicin + levofloxacin and rifampicin + isoniazid have occurred. Objective: The study intended to analyze the therapeutic effects of rifampicin + levofloxacin compared to rifampicin + isoniazid in the treatment of pulmonary TB to provide a clinical reference, which could provide new references for future clinical treatment of the disease. Design: The research team conducted a prospective controlled study. Setting: The study took place at Zibo Zhoucun District People's Hospital in Zibo, China. Participants: Participants were 100 patients with pulmonary TB admitted to the hospital between March 2021 and December 2022. Interventions: The research team assigned participants to one of two groups (1) the intervention group, with 56 participants who received rifampicin + levofloxacin therapy, and (2) the control group, with 44 participants who received rifampicin + isoniazid. Outcome Measures: The research team measured (1) clinical efficacy, (2) incidence of adverse reactions, (3) changes in inflammatory factors, (4) changes in immunoglobulins (Igs), and (5) changes in T lymphocyte subsets. Results: The intervention group's total effective rate for treatment was significantly higher than that of the control group (P = .049). However, no significant difference existed between the groups in the incidence of adverse reactions (P > .05). Postintervention, the intervention group's inflammatory factors-IL-6, TNF-α, hs-CRP, and ß-EP-were significantly lower and its immunoglobulins (Igs) G/A/M (IgG/A/M) were significantly higher than those of the control group (P < .05). In addition, the intervention group's T lymphocyte subpopulations of CD3+ and CD4+ and CD4+/CD8+ were significantly higher and CD8+ was significantly lower than those in the control group (P < .05). In other words, the intervention group had a better immune function. Conclusions: Compared with rifampicin + isoniazid, rifampicin + levofloxacin had a better clinical effect in the treatment of pulmonary TB and could effectively regulate patients' immune functions and inhibit inflammatory reactions. The current research team recommends that rifampicin + levofloxacin become the preferred treatment for pulmonary TB in the absence of a drug allergy.