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Moxifloxacin Improves Outcomes in Hospitalized Pneumonia Patients
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free mobile app. Download Now NEW YORK (Reuters Health) Oct 21 - When patients are hospitalized with community-acquired pneumonia, the fluoroquinolone moxifloxacin has a lower failure rate than beta-lactam monotherapy, and it costs less, too.
European researchers reported that finding online September 29th in the European Respiratory Journal.
Lead author Dr. Sebastian R. Ott of University Hospital and the University of Bern, Switzerland and colleagues say the rate of treatment failure in patients hospitalized with community-acquired pneumonia (CAP) is around 15%. Failure in turn usually leads to longer hospital stays and higher costs.
The data they published last month are from two cohort studies involving a total of 1,236 patients in 22 community hospitals in Germany.
The patients were analyzed as a group, stratified by initial treatment: IV moxifloxacin, or any other antibiotic.
Treatment failure -- seen in 197 patients (15.9%) -- was significantly less likely with moxifloxacin than with other agents (10.9% vs 20.6%).
Treatment failure was correlated with pneumonia severity.
Failure increased the median treatment cost significantly, from 1,284 to 2,206 Euros (or about US$1,781 to $3,060).
Overall, 48.2% of patients received moxifloxacin. More than 90% of the other patients received beta-lactam antibiotics, and almost half had a combination of a beta lactam along with a macrolide.
Combination therapy led to less treatment failure than beta-lactam monotherapy (15.5% vs 21.5%). The difference was most marked in patients with severe CAP (12.9% vs 26.7%).
Direct comparison of initial moxifloxacin and combination therapy showed no significant difference, but on multivariate analysis the rate of failure was lower with moxifloxacin.
Compared to use of the fluoroquinolone, the risk reduction was more comparable with combination treatment than with beta-lactam monotherapy (odds ratio 0.68 vs 0.43).
The researchers conclude that treatment failure appears to be least likely with either moxifloxacin or combination therapy.
They also warn, however, that "taking into account the worldwide emerging threat of antimicrobial resistance, it is crucial to avoid uncritical use" of fluoroquinolones.
Dr. Ott did not respond to requests for comments.
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