title: Clinical efficacy of moxifloxacin versus comparator therapies for community-acquired pneumonia caused by Legionella spp.
abstract: 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 moxifloxacin in 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.
authors.affiliation: Hospital Universitari Mutua de Terrassa, University of Barcelona, Spain. jgarau@garma.e.telefonica.net
authors.forename: J
authors.initials: J
authors.lastname: Garau
authors.forename: A
authors.initials: A
authors.lastname: Fritsch
authors.forename: P
authors.initials: P
authors.lastname: Arvis
authors.forename: R C
authors.initials: RC
authors.lastname: Read
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007875:Legionella; D007876:Legionellosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D015337:Multicenter Studies as Topic; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D011804:Quinolines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin