Moxifloxacin monotherapy versus beta-lactam-based standard therapy for community-acquired pneumonia: a meta-analysis of randomised controlled trials.
The aim of this study was to compare more conclusively the efficacy and safety of moxifloxacin, a new respiratory fluoroquinolone antibiotic, with beta-lactam-based standard therapy, which has been reported to possess good efficacy for community-acquired pneumonia (CAP). A meta-analysis of randomised controlled trials (RCTs) identified in PubMed, the Cochrane Library and Embase was performed. Seven RCTs, involving 3903 patients, were included in the meta-analysis. Moxifloxacin monotherapy was associated with similar clinical treatment success rates [clinically evaluable population, odds ratio (OR)=1.15, 95% confidence interval (CI) 0.81-1.64; intention-to-treat population, OR=1.11, 95% CI 0.86-1.42] and similar mortality (OR=0.98, 95% CI 0.66-1.46) compared with beta-lactam-based standard therapy for CAP. Microbiological treatment success rates in the moxifloxacin group were significantly higher than in the beta-lactam-based therapy group with a statistical margin (OR=1.69, 95% CI 1.02-2.80). No difference was found regarding the incidence of adverse events and serious adverse events between moxifloxacin and beta-lactam-based standard therapy. This meta-analysis provides evidence that moxifloxacin not only can be used as effectively and safely as beta-lactam-based standard therapy for CAP but also possesses a favourable pathogen eradication rate. The once-daily dosing of moxifloxacin monotherapy may be a useful alternative for beta-lactam-based standard therapy.
An
Mao Mao
MM
R&D Center of New Drugs, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, PR China.
Zou
Zui
Z
Shen
Hui
H
Gao
Ping Hui
PH
Cao
Yong Bing
YB
Jiang
Yuan Ying
YY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D024841:Fluoroquinolones; D006801:Humans; D008875:Middle Aged; D000077266:Moxifloxacin; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D011804:Quinolines / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult; D047090:beta-Lactams / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D047090:beta-Lactams; D000077266:Moxifloxacin