Fluoroquinolone therapy for uncomplicated skin and skin structure infections : a retrospective database comparison of treatment duration, failures and charges.
OBJECTIVE
Uncomplicated skin and skin structure infections (uSSSIs) are highly prevalent and costly. With the rising prevalence of bacterial resistance to older antibacterials, there has been an increase in the use of fluoroquinolones for the treatment of uSSSIs creating the need for comparative information. The objective of this study was to compare, under real-world conditions, the treatment duration, failure rates and treatment charges associated with initiation of outpatient treatment for uSSSIs with moxifloxacin versus levofloxacin.


METHODS
This retrospective study was conducted using claims data (April 1999 through March 2002) from the PharMetrics Patient-Centric Database. A cohort was created of patients who had treatment for a uSSSI that was initiated with either moxifloxacin or levofloxacin. The endpoints evaluated were: treatment duration, treatment failure and total charges. Logistic and ordinary least-squares regression analyses were used to test for differences among treatment groups whilst controlling for demographic and clinical characteristics.


RESULTS
506 patients were identified, representing 517 uSSSI treatment episodes. The mean durations of monotherapy and all antibacterial prescription therapy were significantly shorter for the moxifloxacin than the levofloxacin group (differences of 1.97 days [p = 0.015] and 1.60 days [p = 0.036], respectively). The original prescription duration, treatment failure rate and treatment charges were lower for the moxifloxacin group than the levofloxacin group, but differences were not statistically significant (p = 0.241, 0.395 and 0.199, respectively).


CONCLUSIONS
In general, patients who initiated therapy for a uSSSI with moxifloxacin had a shorter duration of antibacterial therapy than those who initiated treatment with levofloxacin, with comparable treatment failure and cost outcomes. When a fluoroquinolone is required for the treatment of a uSSSI, moxi- floxacin (which is approved for 7-day therapy) provides comparable outcomes to levofloxacin under real-world conditions.
Keating
Karen N
KN
Bayer Pharmaceuticals Corporation, West Haven, Connecticut, USA.
Friedman
Howard
H
Perfetto
Eleanor M
EM