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Moxifloxacin: a review of its clinical potential in the management of community-acquired respiratory tract infections.
Drugs. 2000 Jan; 59(1):115-39.D

Abstract

Moxifloxacin is an extended-spectrum fluoroquinolone which has improved coverage against gram-positive cocci and atypical pathogens compared with older fluoroquinolone agents, while retaining good activity against gram-negative bacteria. The antibacterial spectrum of moxifloxacin includes all major upper and lower respiratory tract pathogens; it is one of the most active fluoroquinolones against pneumococci, including penicillin- and macrolide-resistant strains. In in vitro studies, emergence of bacterial resistance was less common with moxifloxacin than with some other fluoroquinolones, but this requires confirmation in large-scale clinical studies. As with other fluoroquinolones, moxifloxacin achieves good penetration into respiratory tissues and fluids. It shows a low potential for drug interactions and dosage adjustment is not required for patients of advanced age or those with renal or mild hepatic impairment. The efficacy of oral moxifloxacin has been demonstrated in large, well-designed clinical trials in patients with community-acquired pneumonia, acute exacerbations of chronic bronchitis or acute sinusitis. Moxifloxacin 400 mg once daily achieved bacteriological and clinical success rates of approximately 90% or higher. It was as effective as, or more effective than, comparators including clarithromycin, cefuroxime axetil and high dose amoxicillin in these trials. The most commonly reported adverse events in patients receiving moxifloxacin are gastrointestinal disturbances. Moxifloxacin is also associated with QTc prolongation in some patients; there are, as yet, no data concerning the possible clinical sequelae of this effect in high-risk patients. Moxifloxacin has a low propensity for causing phototoxic reactions relative to other fluoroquinolones, and animal data suggest that it has a low potential for causing excitatory CNS and hepatotoxic effects.

CONCLUSIONS

As an extended-spectrum fluoroquinolone, moxifloxacin offers the benefits of excellent activity against pneumococci, once daily administration and a low propensity for drug interactions. Although studies are needed regarding its tolerability in at-risk patients with QT interval prolongation, available data suggest that moxifloxacin is likely to become a first-line therapy option for the treatment of community-acquired lower respiratory tract infections, particularly in areas where drug-resistant S. pneumoniae or H. influenzae are common.

Authors+Show Affiliations

Adis International Limited, Mairangi Bay, Auckland, New Zealand.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

10718103

Citation

Balfour, J A., and H M. Lamb. "Moxifloxacin: a Review of Its Clinical Potential in the Management of Community-acquired Respiratory Tract Infections." Drugs, vol. 59, no. 1, 2000, pp. 115-39.
Balfour JA, Lamb HM. Moxifloxacin: a review of its clinical potential in the management of community-acquired respiratory tract infections. Drugs. 2000;59(1):115-39.
Balfour, J. A., & Lamb, H. M. (2000). Moxifloxacin: a review of its clinical potential in the management of community-acquired respiratory tract infections. Drugs, 59(1), 115-39.
Balfour JA, Lamb HM. Moxifloxacin: a Review of Its Clinical Potential in the Management of Community-acquired Respiratory Tract Infections. Drugs. 2000;59(1):115-39. PubMed PMID: 10718103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Moxifloxacin: a review of its clinical potential in the management of community-acquired respiratory tract infections. AU - Balfour,J A, AU - Lamb,H M, PY - 2000/3/16/pubmed PY - 2000/4/1/medline PY - 2000/3/16/entrez SP - 115 EP - 39 JF - Drugs JO - Drugs VL - 59 IS - 1 N2 - UNLABELLED: Moxifloxacin is an extended-spectrum fluoroquinolone which has improved coverage against gram-positive cocci and atypical pathogens compared with older fluoroquinolone agents, while retaining good activity against gram-negative bacteria. The antibacterial spectrum of moxifloxacin includes all major upper and lower respiratory tract pathogens; it is one of the most active fluoroquinolones against pneumococci, including penicillin- and macrolide-resistant strains. In in vitro studies, emergence of bacterial resistance was less common with moxifloxacin than with some other fluoroquinolones, but this requires confirmation in large-scale clinical studies. As with other fluoroquinolones, moxifloxacin achieves good penetration into respiratory tissues and fluids. It shows a low potential for drug interactions and dosage adjustment is not required for patients of advanced age or those with renal or mild hepatic impairment. The efficacy of oral moxifloxacin has been demonstrated in large, well-designed clinical trials in patients with community-acquired pneumonia, acute exacerbations of chronic bronchitis or acute sinusitis. Moxifloxacin 400 mg once daily achieved bacteriological and clinical success rates of approximately 90% or higher. It was as effective as, or more effective than, comparators including clarithromycin, cefuroxime axetil and high dose amoxicillin in these trials. The most commonly reported adverse events in patients receiving moxifloxacin are gastrointestinal disturbances. Moxifloxacin is also associated with QTc prolongation in some patients; there are, as yet, no data concerning the possible clinical sequelae of this effect in high-risk patients. Moxifloxacin has a low propensity for causing phototoxic reactions relative to other fluoroquinolones, and animal data suggest that it has a low potential for causing excitatory CNS and hepatotoxic effects. CONCLUSIONS: As an extended-spectrum fluoroquinolone, moxifloxacin offers the benefits of excellent activity against pneumococci, once daily administration and a low propensity for drug interactions. Although studies are needed regarding its tolerability in at-risk patients with QT interval prolongation, available data suggest that moxifloxacin is likely to become a first-line therapy option for the treatment of community-acquired lower respiratory tract infections, particularly in areas where drug-resistant S. pneumoniae or H. influenzae are common. SN - 0012-6667 UR - https://www.unboundmedicine.com/medline/citation/10718103/Moxifloxacin:_a_review_of_its_clinical_potential_in_the_management_of_community_acquired_respiratory_tract_infections_ L2 - https://dx.doi.org/10.2165/00003495-200059010-00010 DB - PRIME DP - Unbound Medicine ER -