Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors.
BACKGROUND
Community-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.


METHODS
In this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.


RESULTS
Seven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (χ(2) = 4.002, P < 0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P > 0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P > 0.05). No serious adverse events were observed.


CONCLUSIONS
Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.
Department of Respiratory and Critical Care Medicine, Beijing Hospital of the Ministry of Health, Beijing 100730, China.
Tieying
T
Sun
Department of Respiratory Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China.
Li
L
Sun
Department of Respiratory Diseases, Air Force General Hospital, People's Liberation Army, Beijing 100142, China.
Rongmei
R
Wang
Department of Respiratory Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China.
Xiaoping
X
Ren
Department of Respiratory Diseases, Air Force General Hospital, People's Liberation Army, Beijing 100142, China.
Dong-Jiang
DJ
Sui
Department of Respiratory and Critical Care Medicine, Beijing Hospital of the Ministry of Health, Beijing 100730, China.
Chun
C
Pu
Department of Respiratory Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China.
Yajuan
Y
Ren
Department of Respiratory Diseases, Air Force General Hospital, People's Liberation Army, Beijing 100142, China.
Ying
Y
Liu
Department of Respiratory Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China.
Zhuo
Z
Yang
Department of Respiratory Diseases, Air Force General Hospital, People's Liberation Army, Beijing 100142, China.
Fengzhi
F
Li
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006801:Humans; D064704:Levofloxacin / Q000627:therapeutic use*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D000077266:Moxifloxacin; D011014:Pneumonia / Q000188:drug therapy*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D008795:Metronidazole; D064704:Levofloxacin; D000077266:Moxifloxacin