A brief review of moxifloxacin in the treatment of elderly patients with community-acquired pneumonia (CAP)

Figures & data

Table 1 Summary of main recent clinical trials with moxifloxacin in adult and old patients with community acquired-pneumonia

Authors	Study design	No. of patients PPP	Treatment	Test of cure (TOC)	Clinical success in PPP (%)	Bacteriological successa No. of patients (%)	Age mean values ± SD(range)	PSI classb
Fogarty 1999	Randomized double-blind	382	10 days MXF po 400 mg od (n = 194)	End of therapy	97.0	99 (97.0)	48	NA
			10 days CLA po 500 mg bid (n = 188)		95.0	100 (93.0)	49
Patel 2000	Open-label non comparative	196	10 days MXF po 400 mg od	0–6 days post therapy	94.0	106 (91.0)	49 (18–85)	NA
Hoeffken 2001	Randomized double-blind	531	10 days MXF po 200 mg od (n = 180)	3–5 days post therapy	93.9	29 (72.5)	48.4 ± 20.6	NA
			10 days MXF po 400 mg od (n = 177)		94.4	37 (78.7)	48.0 ± 20.8
			10 days CLA po 500 mg bid (n = 174)		94.3	29 (70.7)	48.2 ± 19.2
Petitpretz 2001	Randomized double-blind	362	10 days MXF po 400 mg od (n = 177)	3–5 days post therapy	91.5	61 (89.7)	52.0 ± 20.5 (≥70: 25%)	NA
			10 days AMX po 1000 mg tid (n = 185)		89.7	56 (82.4)	49.9 ± 20.6 (≥70: 22%)
Finch 2002	Randomized open-label	538	7–14 days MXF iv/po 400 mg od (n = 258)	5–7 days post therapy	93.4	60 (93.7)	55.2 ± 20.6	NA
			7–14 days AMX-CLAV iv(1200 mg tid)/po (625 mg tid) ± CLA iv/po (500 mg bid) (n = 280)		85.4	58 (81.7)	55.9 ± 19.6
Torres 2003	Randomized double-blind	446	Up to 14 days MXF po 400 mg od (n = 215)	7–10 days post therapy	93.5	NA	52.7 ± 18.7 (≥70: 22%)	I–III 80.6%
								IV 17.6%
								V 1.7%
			Up to 14 days AMX (1000 mg tid) or CLA (500 mg bid) alone or in combination (n = 231)		93.9	NA	49.3 ± 18.7 (≥70: 18%)	I–III 84.9%
								IV 13.9%
								V 1.2%
Jardim 2003	Randomized double- blind CAP with S. pneumoniae infection	70	10 days MXF po 400 mg od (n = 34)	3–5 days post therapy	94.1	15 (88.2)	51.9 (>65: 28.2%)	NA
			10 days AMX 500 mg tid (n = 36)		91.7	14 (87.5)	48.6 (>65: 31.1%)
Katz 2004	Randomized open- label	221	7–10 days MXF iv/po 400 mg od (n = 108)	7–14 days post therapy	83.3	14 (82.3)	59.4 ± 19 (18–93)	I–III 75.0%
								IV 20.0%
								V 5.0%
			7–10 days CRO (2000 mg iv qd) → FUR (500 mg po bid) ± AZM ± MTZ (n = 113)		79.6	15 (62.5)	58.7 ± 20.5 (18–94)	I–III 77.0%
								IV 18.0%
								V 5.0%
Portier 2005	Randomized open-label	289	10 days MXF po 400 mg od (n = 151)	5–7 days post therapy	86.8	23 (76.7)	59.3±17.9 (>65: 46.8%)	NA
			10 days AMX-CLAV (1000/125 mg tid) + ROX (150 mg bid) (n = 138)		87.0	23 (74.2) (>65: 53.1%)	62.4±18
Fogarty 2005	Pooled data from 6 non-comparative trials (S.pneumoniae CAP)	131	7–14 days MXF po or iv/po 400 mg od	7–35 days post therapy	95.4	104 (92.9)	56.4 (20–88)	NA
Welte 2005	Randomized open-label	317	7–14 days MXF iv/po 400 mg od (n = 161)	5–20 days post therapy	85.7	NA	(≥65: 43.5%)	I–III 83.2%
								IV 16.1%
								V 0.6%
			7–14 days CRO (2000 mg od) ± ERY(1000 mg iv tid) (n = 156)		86.5	NA	(≥65: 41.0%)	I–III 82.7%
								IV 16.7%
								V 0.6%
Anzueto 2006	Randomized double-blind	281	7–14 days MXF iv/po 400 mg od (n = 141)	5–21 days post therapy	92.9	17 (81.0)	77.9±7.1 (65–95) (>75: 64.5%	I–III 48.2%
								IV 29.1%
								V 7.1%
								13.5% c
			7–14 days LEV iv/po 500 mg od (n = 140)		87.9	21 (75.0)	77.4±7.7 (65–98)	I–III 40.7%
								IV 36.4%
								V 4.3%
								18.6% c

^a eradication/presumed eradication in microbiologically valid population.

^b PSI, pneumonia severity index score (Fine et al 1997).

^c severe ATS CAP severity score according to guidelines of the American Thoracic Society (Niederman et al 2001).

Abbreviations: AMX, amoxicillin; AMX-CLA, amoxicillin-clavulanate; AZM, azithromycin; CLA, clarithromycin; CRO, ceftriaxone; ERY, erithromycin; FUR, cefuroxime; LEV, levofloxacin; MTZ, metronidazole; MXF, moxifloxacin; n, number of patients; PPP, per-protocol population; ROX, roxithromycin.

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