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Moxifloxacin + rifampicin is a fixed-dose combination of two small molecule antibiotics used primarily in the treatment of tuberculosis (TB), including isoniazid-resistant or drug-susceptible TB with isoniazid intolerance, as well as for certain non-staphylococcal Gram-positive implant-related infections. Moxifloxacin is a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, leading to inhibition of DNA replication and cell death. Rifampicin (also known as rifampin) inhibits bacterial DNA-dependent RNA polymerase, suppressing RNA synthesis and thus protein production. The combination has been shown to be synergistic in suppressing resistance emergence but may be antagonistic for rapid cell kill against Mycobacterium tuberculosis. Co-administration results in reduced plasma concentrations of moxifloxacin due to induction of hepatic metabolism by rifampicin; dose adjustments may be necessary[1][3][5]. This regimen has also demonstrated efficacy against non-staphylococcal Gram-positive orthopedic implant-related infections due to its activity on biofilm-forming bacteria[2].
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