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Clinical and bacteriological efficacy of sequential intravenous to oral moxifloxacin in hospitalised patients with community-acquired pneumonia and pneumococcal bacteraemia

Abstract number: 1733_1517

Choudhri S., Arvis P., Haverstock D.

Objectives:Streptococcus pneumoniae is the leading bacterial pathogen in patients with community-acquired pneumonia (CAP) and the presence of pneumococcal bacteraemia in this setting is associated with significant morbidity and mortality. Pooled data from 6 CAP trials were used to compare the clinical and microbiological efficacy of sequential intravenous (IV)/oral (PO) moxifloxacin (MXF) with comparator (COMP) therapy in patients with pneumococcal bacteraemia.

Methods: Data were pooled from all 6 of the sequential trials carried out on 400 mg (IV/PO) MXF in the treatment of CAP in hospitalised patients. COMP treatment consisted of ceftriaxone + erythromycin, amoxicillin/clavulanate ± clarithromycin, trovafloxacin, levofloxacin, ceftriaxone ± azithromycin ± metronidazole or ceftriaxone + levofloxacin. All patients had blood cultures performed prior to initiation of study drug therapy. Severe CAP was defined using the modified ATS criteria.

Results: The 6 trials randomised 3015 patients (1494 MXF, 1521 COMP) of which 2288 were valid per protocol (PP) (1141 MXF, 1147 COMP). Of the valid PP patients, 342 MXF and 361 COMP-treated subjects were also microbiologically valid. Of these 178 (52.0%) MXF and 192 (53.2%) COMP-treated subjects had CAP due to S. pneumoniae with 48 (14.0%) MXF and 64 (17.7%) COMP patients having pneumococcal bacteraemia. Clinical and bacteriological success rates of MXF and COMP therapy in patients with pneumococcal bacteraemia.

Clinical and bacteriological success rates of MXF and COMP therapy in patients withpneumococcal bacteraemia

 MXF n/N (%)COMP n/N (%)
Overall clinical success40/48 (83.3%)49/64 (76.6%)
Clinical success in patients with severe CAP13/19 (68.4%)18/31 (58.1%)
Overall bacteriological success42/48 (87.5%)50/64 (78.1%)

Conclusions: Sequential therapy with IV/PO MXF resulted in higher clinical and bacteriological success rates than comparator therapy in patients with CAP associated with pneumocococcal bacteraemia, including patients with severe CAP.

Research funding: Bayer HealthCare Pharmaceuticals.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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