Safety and efficacy of sequential i.v. to p.o. moxifloxacin versus conventional combination therapies for the treatment of community-acquired pneumonia in patients requiring initial i.v. therapy

J Emerg Med. 2004 Nov;27(4):395-405. doi: 10.1016/j.jemermed.2004.02.023.

Abstract

To compare the efficacy of sequential i.v. to p.o. moxifloxacin with ceftriaxone +/- azithromycin +/- metronidazole for the treatment of patients with community acquired pneumonia (CAP), a multi-centered, prospective, randomized, open label study was performed. CAP patients were randomized to moxifloxacin (400 mg/d-at least one i.v. dose) or ceftriaxone (at least one dose of 2 g i.v. q.d. followed by cefuroxime 500 mg p.o. b.i.d.) +/- azithromycin, +/- metronidazole (cephalosporin/macrolide control: CMC). The primary endpoint was clinical response at test-of-cure (TOC) visit. Bacteriological response at TOC was the secondary endpoint. Clinical cure was found in 83.3% (90/108) of moxifloxacin patients and 79.6% (90/113) of control patients. Microbiological responses were 81.8% (18/22) for moxifloxacin and 60.7% (17/28) for CMC patients. Drug-related adverse events occurred in 18.0% of moxifloxacin and 16% of CMC patients. It is concluded that i.v. to p.o. moxifloxacin is as effective as CMC for treatment of CAP and is a reliable alternative antimicrobial therapy.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / therapeutic use
  • Aza Compounds / adverse effects
  • Aza Compounds / therapeutic use*
  • Azithromycin / adverse effects
  • Azithromycin / therapeutic use
  • Ceftriaxone / adverse effects
  • Ceftriaxone / therapeutic use
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / ethnology
  • Constipation / chemically induced
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / therapeutic use*
  • Emergency Medical Services
  • Female
  • Fluoroquinolones
  • Humans
  • Male
  • Metronidazole / adverse effects
  • Metronidazole / therapeutic use
  • Middle Aged
  • Moxifloxacin
  • Nausea / chemically induced
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / microbiology
  • Prospective Studies
  • Quinolines / adverse effects
  • Quinolines / therapeutic use*
  • Safety
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Metronidazole
  • Ceftriaxone
  • Azithromycin
  • Moxifloxacin