title: Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD.
abstract: This study was designed to investigate the efficacy of moxifloxacin for the eradication of bacterial colonisation of the airways in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Out of 119 stable patients with COPD screened, 40 (mean age 69 yrs, mean forced expiratory volume in 1 s 50% predicted) were colonised with potentially pathogenic microorganisms (PPMs) and were included in a randomised, double-blind, placebo-controlled trial with moxifloxacin 400 mg daily for 5 days. Eradication rates were 75% with moxifloxacin and 30% with placebo at 2 weeks (p = 0.01). Bacterial persistence at 8 weeks was still higher (not significantly) in the placebo arm (five (25%) out of 20 versus one (5%) out of 20; p = 0.18). The frequencies of acquisition of a new PPM were high and similar in both treatment groups; consequently, the prevalence of colonisation at 8 weeks was also similar between treatment arms. No difference was found in the number of patients with exacerbations during the 5-month follow-up. Only the acquisition of a new PPM during follow-up showed a statistically significant relationship with occurrence of an exacerbation. Moxifloxacin was effective in eradicating PPMs in patients with positive sputum cultures. However, most patients were recolonised after 8 weeks of follow-up. Acquisition of a new strain of bacteria was associated with an increased risk of developing an exacerbation.
authors.affiliation: Fundació Clínic, Institut D'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain. marcm@clinic.ub.es
authors.forename: M
authors.initials: M
authors.lastname: Miravitlles
authors.forename: A
authors.initials: A
authors.lastname: Marín
authors.forename: E
authors.initials: E
authors.lastname: Monsó
authors.forename: S
authors.initials: S
authors.lastname: Vilà
authors.forename: C
authors.initials: C
authors.lastname: de la Roza
authors.forename: R
authors.initials: R
authors.lastname: Hervás
authors.forename: C
authors.initials: C
authors.lastname: Esquinas
authors.forename: M
authors.initials: M
authors.lastname: García
authors.forename: L
authors.initials: L
authors.lastname: Millares
authors.forename: J
authors.initials: J
authors.lastname: Morera
authors.forename: A
authors.initials: A
authors.lastname: Torres
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques; D001980:Bronchi / Q000187:drug effects* / Q000382:microbiology*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D010919:Placebos; D016133:Polymerase Chain Reaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D011804:Quinolines / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D010919:Placebos; D011804:Quinolines; D000077266:Moxifloxacin