Clinical and bacteriological efficacy of sequential intravenous to oral moxifloxacin in hospitalised patients with community-acquired pneumonia and bacteraemia
Abstract number: R2532
Arvis P., Haverstock D., Choudri S.H.
Objectives: To compare the clinical and microbiological efficacy of sequential IV/PO moxifloxacin (MXF) with comparator (COMP) therapy in patients with community acquired pneumonia (CAP) and bacteraemia.
Methods: Data were pooled from 6 trials of MXF 400 mg (IV/PO) in the treatment of CAP in hospitalised patients. COMP treatments were ceftriaxone + erythromycin, amoxicillin/clavulanate + clarithromycin, trovafloxacin, levofloxacin, ceftriaxone + azithromycin + metronidazole or ceftriaxone + levofloxacin. Blood cultures were performed prior to initiation of study drug therapy.
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. 68 (6.0%) patients in the MXF group and 83 (7.2%) in the COMP group had bacteraemia. Of these, 40 (58.8%) in the MXF group and 48 (57.8%) in the COMP group, were male, 20 (29.4%) and 17 (20.5%) were 75 years old, 12 (17.6%) and 14 (16.9%) had bilateral infiltrates and 28 (41.2%) and 39 (47.0%) had severe CAP (ATS 2001 criteria). S. pneumoniae was the most common pathogen (MXF 48, COMP 64), with a range of other pathogens occurring less often including S. aureus (5, 2), H. influenzae (4, 4), E. coli (2, 3). Efficacy data at test-of-cure for the bacteraemic population are shown in the table. Clinical success rates in the non-bacteraemic population were MXF 89.1% and COMP 87.7%.
Conclusions: Monotherapy with MXF (IV/PO) resulted in clinical and overall bacteriological success rates similar to those of COMP therapy in patients with CAP and bacteraemia. The bacteriological success rate in bacteraemic patients with S. pneumoniae was numerically higher with MXF.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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