Clinical Experience in Germany of Treating Community-Acquired Respiratory Infections with the New 8-Methoxyfluoroquinolone, Moxifloxacin

Abstract

Moxifloxacin, a new 8-methoxyfluoroquinolone, was evaluated in a large community-based study involving 16,007 patients over a 9-month period. This study was designed as a large post-marketing observational study of the speed, efficacy and tolerability of moxifloxacin when used in clinical practice for the treatment of community-acquired bacterial pneumonia, or acute exacerbations of chronic bronchitis. Physicians and patients were specifically questioned about overall efficacy and safety as well as symptom relief. According to physicians' assessments 96.3% of patients were cured or improved after moxifloxacin treatment. Symptom relief ('feeling better') occurred in almost 70% of patients by day 3 and only 2.3% reported an adverse drug reaction. No individual adverse drug reaction was reported at a frequency above 1%. Among the 209 events considered as serious, only 34 were regarded as possibly or probably related to therapy. There were no moxifloxacin-related clinically relevant cases of phototoxicity, hepatotoxicity or cardiotoxicity. Overall, 92.1% of patients considered moxifloxacin to have been beneficial.

Moxifloxacina: profilo farmacologico, terapeutico e farmacoeconomico

“…L'efficacia clinica e la tollerabilità della moxifloxacina nella CAP, nelle AECB e nelle ABS sono state studiate su un numero elevato di pazienti, nel corso di diversi trial multicentrici controllati, nazionali e internazionali, strutturati nella maggior parte come studi in doppio cieco [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118].…”

“…L'elevata efficacia clinica della moxifloxacina nella CAP è stata confermata anche in diverse ricerche cliniche condotte in aperto [105,106].…”

Moxifloxacin and Azithromycin but not Amoxicillin Protect Human Respiratory Epithelial Cells against Streptococcus pneumoniae In Vitro when Administered up to 6 Hours after Challenge

“…Based on in vitro data (2,3,9), animal models of pneumococcal infection (2), and several clinical studies (1,4,6,10,11,22), moxifloxacin has been suggested for the treatment of these infections (7,20). The rapid and positive clinical efficacy of moxifloxacin (10,11,18) can be explained by the high bactericidal capacity against leading pathogens in CAP and AECB (3) and the achievement of high drug concentrations at the site of infection as a consequence of adequate tissue drug penetration. Indeed, quinolone antibiotics penetrate well into various tissues, including the respiratory tract (8,14,16,17,23) and into phagocytic (12,15) and epithelial cells (15,19).…”

“…Streptococcus pneumoniae is the leading gram-positive pathogen in patients with community-acquired pneumonia (CAP) (10) and is second after Haemophilus influenzae in patients with acute exacerbations of chronic bronchitis (AECB) (4,11). In the treatment of CAP and AECB, penicillin-and macrolide-resistant pneumococci have become an increasing problem (5,16).…”

“…In the treatment of CAP and AECB, penicillin-and macrolide-resistant pneumococci have become an increasing problem (5,16). Based on in vitro data (2,3,9), animal models of pneumococcal infection (2), and several clinical studies (1,4,6,10,11,22), moxifloxacin has been suggested for the treatment of these infections (7,20). The rapid and positive clinical efficacy of moxifloxacin (10,11,18) can be explained by the high bactericidal capacity against leading pathogens in CAP and AECB (3) and the achievement of high drug concentrations at the site of infection as a consequence of adequate tissue drug penetration.…”