| Title | Sequential IV/PO moxifloxacin treatment of patients with severe community-acquired pneumonia. | | Author(s) | Lode H, Grossman C, Choudhri S, Haverstock D, McGivern J, Herman-Gnjidic Z, Church D | | Institution | Zentralklinik Emil von Behring, Lungenklinik Heckeshorn, Berlin 10115, Germany. haloheck@zedat.fu-berlin.de | | Source | Respir Med 2003 Oct; 97(10):1134-42. | | MeSH | Adolescent
Adult
Aged
Aged, 80 and over
Aza Compounds
Clarithromycin
Community-Acquired Infections
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Fluoroquinolones
Humans
Male
Middle Aged
Naphthyridines
Pneumonia, Bacterial
Quinolines
Research Support, Non-U.S. Gov't
Retrospective Studies
Treatment Outcome
| | Abstract | BACKGROUND: IV/PO moxifloxacin was evaluated in the treatment of hospitalized patients with severe community-acquired pneumonia (CAP).
METHODS: Data were pooled from two prospective, randomized studies. In the multinational study, patients received 7-14 days IV/PO moxifloxacin 400 mg QD or IV/ PO amoxicillin clavulanate 1200/625 mg TID +/- IV/PO clarithromycin 500 mg BID. In the North American study, patients received 7-14 days IV/PO moxifloxacin 400 mg QD, IV/ PO alatrofloxacin/trovafloxacin 200 mg QD, or IV/PO levofloxacin 500 mg QD. The primary endpoint was clinical success at the test-to-cure visit. Severe CAP was defined according to the 1993 ATS criteria.
RESULTS: In the clinically valid population, clinical success rates were 88% (167/190) for moxifloxacin- and 83% (155/186) for comparator-treated patients (95% CI = -1.9%, 12.2%). Corresponding clinical success rates for the microbiologically valid population were 87% (59/68) and 84% (54/64), respectively (95% CI = 8.6%, 15.0%). A switch from IV to PO therapy was made by day 5 of therapy for 73% of moxifloxacin- vs. 60% of comparator-treated patients (P < 0.01). Clinical success rates were similar in a retrospective analysis using the revised 2001 ATS definition of severe CAP. Mortality rates were 6% (15/241) and 10% (24/238) in the moxifloxacin and comparator treatment groups, respectively. The incidence of drug-related adverse events was similar in both treatment groups.
CONCLUSION: Sequential IV/PO moxifloxacin 400 mg QD is as safe and effective as other fluoroquinolones and a beta-lactam/macrolide combination for treating hospitalized patients with severe CAP. | | Language | eng | | Pub Type(s) | Clinical Trial
Clinical Trial, Phase III
Journal Article
Multicenter Study
Randomized Controlled Trial
| | PubMed ID | 14561021 |
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