Clinical Efficacy of Moxifloxacin Versus Comparator Therapies for Community-Acquired Pneumonia Caused by Legionella spp

• Published in: Journal of chemotherapy (Florence) 2010-08, Vol.22 (4), p.264-266
• Main Authors: Garau, J., Fritsch, A., Arvis, P., Read, R.C.
• Format: Article
• Language: English
• Subjects: Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Aza Compounds - therapeutic use; Biological and medical sciences; clinical trials; Community-Acquired Infections - drug therapy; community-acquired pneumonia; Female; Fluoroquinolones; Humans; Legionella; Legionellosis - drug therapy; Male; Medical sciences; Middle Aged; moxifloxacin; Multicenter Studies as Topic; Pharmacology. Drug treatments; Pneumonia, Bacterial - drug therapy; Quinolines - therapeutic use; Randomized Controlled Trials as Topic; Treatment Outcome
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/joc.2010.22.4.264

The aim of this study was to compare outcomes for patients with community-acquired pneumonia (CAP) caused by Legionella spp. following treatment with moxifloxacin or a range of comparator antimicrobial agents. Data were pooled from four sequential I.V./P.O. trials of moxifloxacinin the treatment of CAP. Comparators were ceftriaxone ± erythromycin, amoxicillin/clavulanate ± clarithromycin, trovafloxacin, levofloxacin, or ceftriaxone + levofloxacin. Legionella infection was diagnosed by culture, urine antigen testing and/or serology. Clinical success rates for the efficacy-valid (per protocol) populations were recorded at the test-of-cure visit (5-30 days post-therapy). Severity of CAP was determined using the modified American thoracic Society criteria. Of 1786 efficacy-valid patients, 33 (1.8%) had documented infection with Legionella spp. (moxifloxacin: n=13; comparator: n=20). Of these, 30 cases were identified by serology and/or urine antigen detection and 3 by respiratory culture. The success rate of moxifloxacin vs. comparator therapy was 92.3% vs. 80.0% for the I.V./P.O. trials. Sequential (I.V./P.O.) moxifloxacin demonstrated clinical efficacy that was at least as good as that of comparator treatments for the treatment of CAP due to Legionella.