Moxifloxacin vs ampicillin/sulbactam in aspiration pneumonia and primary lung abscess.
BACKGROUND
Aspiration pneumonia (AP) and primary lung abscess (PLA), are diseases following aspiration of infectious material from the oropharynx or stomach. An antibiotic therapy, also covering anaerobic pathogens, is the treatment of choice. In this study we compared moxifloxacin (MXF) and ampicillin/sulbactam (AMP/SUL) concerning efficacy and safety in the treatment of AP and PLA.


METHODS
Patients with pulmonary infections following aspiration were included in a prospective, open-label, randomized, multicenter trial. Sequential antibiotic therapy with MXF or AMP/SUL was administered until complete radiologic and clinical resolution.


RESULTS
A total of 139 patients with AP and PLA were included, 96 were evaluable for efficacy (EE, 48 patients in each treatment group). The overall clinical response rates in both groups were numerically identical (66.7%). MXF and AMP/SUL were both well tolerated, even after long-term administration [median duration of treatment (range) in days MXF versus AMP/SUL: AP 11 (4-45) vs 9 (3-25), PLA 30.5 (7-158) vs 35 (6-90)].


CONCLUSIONS
In the treatment of aspiration-associated pulmonary infections moxifloxacin appears to be clinically as effective and as safe as ampicillin/sulbactam; but, however, having the additional benefit of a more convenient (400 mg qd) treatment.
Ott
S R
SR
Helios Chest Hospital Heckeshorn, Department of Chest and Infectious Diseases, Affiliated to Charité, University of Medicine Berlin, Walterhöfer Str. 11, D-14165, Berlin, Germany. sebastian.ott@helios-kliniken.de
Allewelt
M
M
Lorenz
J
J
Reimnitz
P
P
Lode
H
H
D000328:Adult; D000667:Ampicillin / Q000009:adverse effects / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001372:Aza Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D024841:Fluoroquinolones; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006092:Gram-Negative Facultatively Anaerobic Rods / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006095:Gram-Positive Cocci / Q000302:isolation & purification; D006801:Humans; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D000077266:Moxifloxacin; D011015:Pneumonia, Aspiration / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D011859:Radiography; D013407:Sulbactam / Q000009:adverse effects / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; C035444:sultamicillin; D000667:Ampicillin; D013407:Sulbactam; D000077266:Moxifloxacin