title: Comparative efficacy and safety of moxifloxacin and clindamycin in the treatment of odontogenic abscesses and inflammatory infiltrates: a phase II, double-blind, randomized trial.
abstract: Moxifloxacin penetrates well into oromaxillary tissue and covers the causative pathogens that show an increasing resistance to standard antibiotics. Clinical reports suggest that moxifloxacin may be effective for the treatment of odontogenic infections that can lead to serious complications. The objective of this prospective, randomized, double-blind, multicenter study was to compare the efficacies and safeties of moxifloxacin and clindamycin for the medical treatment of patients with gingival inflammatory infiltrates and as an adjuvant therapy for patients with odontogenic abscesses requiring surgical treatment. Patients received either 400 mg moxifloxacin per os once daily or 300 mg clindamycin per os four times daily for 5 days consecutively. The primary efficacy endpoint was the percent reduction in patients' perceived pain on a visual analogue scale at days 2 to 3 from baseline. Primary analysis included 21 moxifloxacin- and 19 clindamycin-treated patients with infiltrates and 15 moxifloxacin- and 16 clindamycin-treated patients with abscesses. The mean pain reductions were 61.0% (standard deviation [SD], 46.9%) with moxifloxacin versus 23.4% (SD, 32.1%) with clindamycin (P = 0.006) for patients with infiltrates and 55.8% (SD, 24.8%) with moxifloxacin versus 42.7% (SD, 48.5%) with clindamycin (P = 0.358) for patients with abscesses. A global efficacy assessment at days 2 to 3 and 5 to 7 showed faster clinical responses with moxifloxacin in both abscess and infiltrate patients. Rates of adverse events were lower in moxifloxacin- than in clindamycin-treated patients. In patients with inflammatory infiltrates, moxifloxacin was significantly more effective in reducing pain at days 2 to 3 of therapy than clindamycin. No significant differences between groups were found for patients with odontogenic abscesses.
authors.affiliation: Department of Restorative and Preventive Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. cachovan@uke.uni-hamburg.de
authors.forename: Georg
authors.initials: G
authors.lastname: Cachovan
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Böger
authors.forename: Ina
authors.initials: I
authors.lastname: Giersdorf
authors.forename: Olaf
authors.initials: O
authors.lastname: Hallier
authors.forename: Thomas
authors.initials: T
authors.lastname: Streichert
authors.forename: Munif
authors.initials: M
authors.lastname: Haddad
authors.forename: Ursula
authors.initials: U
authors.lastname: Platzer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schön
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.forename: Ingo
authors.initials: I
authors.lastname: Sobottka
mesh_terms: D000038:Abscess / Q000188:drug therapy* / Q000382:microbiology; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001372:Aza Compounds / Q000627:therapeutic use*; D002981:Clindamycin / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D024841:Fluoroquinolones; D005891:Gingivitis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077266:Moxifloxacin; D020556:Neutrophil Infiltration / Q000187:drug effects*; D011804:Quinolines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D002981:Clindamycin; D000077266:Moxifloxacin