Moxifloxacin for the Treatment of Patients with Complicated Intra-abdominal Infections (the AIDA Study)

Weiß, Günter; Reimnitz, Peter; Hampel, Barbara; Muehlhofer, Eva; Lippert, H.

doi:10.1179/joc.2009.21.2.170

Cited by 44 publications

(57 citation statements)

References 17 publications

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“…Thus, numerous studies discussing their efficacy in comparisons with various betalactams were reported in the literature. Several previous studies indicated similar therapeutic efficacies of FQs and beta-lactams in patients with intra-abdominal infections (respectively, moxifloxacin and ceftriaxone plus metronidazole) (13), urinary tract infections (levofloxacin and doripenem) (14), acute bacterial exacerbation of chronic bronchitis (ciprofloxacin and cefuroxime) (15), and severe sepsis (ciprofloxacin and ceftazidime) (16). However, our study was the first to disclose the therapeutic benefit of FQ therapy in comparison with 3rd-GC therapy for bloodstream infections and also the first report using propensity score matching.…”

Section: Discussionmentioning

confidence: 99%

Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy

Lee

Wang

Hsieh

et al. 2017

Antimicrob Agents Chemother

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Both fluoroquinolones (FQs) and third-generation cephalosporins (3rd-GCs) are commonly prescribed to treat bloodstream infections, but comparative efficacies between them were rarely studied. Demographics and clinical characteristics of 733 adults with polymicrobial or monomicrobial community-onset bacteremia empirically treated by an appropriate FQ (n ϭ 87) or 3rd-GC (n ϭ 646) were compared. A critical illness (respectively, 8.0% versus 19.0%; P ϭ 0.01), an initial syndrome with severe sepsis (33.3% versus 50.3%; P ϭ 0.003), or a fatal outcome at 28 days (4.6% versus 10.5%; P ϭ 0.08) was less common in the FQ group. A total of 645 (88.0%) patients were febrile at initial presentation, and the FQ group with (FQ group versus 3rd-GC group, respectively, 7.6 days versus 12.0 days; P ϭ 0.04) and without (3.8 days versus 5.4 days; P ϭ 0.001) a critical illness had a shorter time to defervescence than the 3rd-GC group. By the propensity scores, 87 patients with appropriate FQ therapy were matched with 435 treated by 3rd-GC therapy at a ratio of 1:5, and there were no significant differences in terms of bacteremia severity, comorbidity severity, major comorbidities, causative microorganisms, and bacteremia sources between groups. Moreover, crude mortality rates at 28 days (FQ group versus 3rd-GC group, respectively, 4.6% versus 7.8%; P ϭ 0.29) did not differ significantly. However, the time to defervescence was shorter in the FQ group (4.2 Ϯ 3.6 versus 6.2 Ϯ 7.6 days; P Ͻ 0.001). Conclusively in the adults with community-onset bacteremia, appropriate empirical FQ therapy was related to shorter time to defervescence than with 3rd-GC therapy, at least for those without a critical illness.

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Section: Discussionmentioning

confidence: 99%

Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy

Lee

Wang

Hsieh

et al. 2017

Antimicrob Agents Chemother

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“…Moxifloxacin, used as monotherapy, has been beneficial in secondary severe intra-abdominal sepsis with high clinical and bacteriological efficacies in hospitalized patients; even with polyorganic insufficiency 7 .This fourth generation fluor quinolone promotes control of sepsis and septic-shock and has a good penetration from the blood into the peritoneal cavity, aiming to control severe peritonitis [21][22][23][24][25][26] . However, its use inside the peritoneal cavity has not yet been tested.…”

Section: Discussionmentioning

confidence: 99%

Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion. Response to intra peritoneal moxifloxacin combined with dexamethasone

Melo

Gadelha²,

Oliveira

et al. 2014

Acta Cir. Bras.

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PURPOSE:To evaluate the treatment outcome of severe peritonitis in rats submitted to permanent bilateral carotid occlusion (PBCO). METHODS:Sixteen Wistar rats (mean age of 8.5 months) with PBCO underwent autogenously fecal peritonitis, and were treated with moxifloxacin combined with dexamethasone, and followed-up for 45 days. Ten rats (mean age five months) without PBCO were used as a control group. The variables were expressed by their mean and standard error of the mean (SEM). p<0.05 was used for rejecting the null hypothesis. The study was approved by the Ethics Committee. RESULTS:There was a significant increase (p=0.0002) in the mortality and morbidity in older rats that underwent PBCO (study group). However, even among the survival rats presenting with severe residual abscesses both in the abdomen and thorax cavities, they present an almost normal life. CONCLUSIONS:The treatment of severe autogenously fecal peritonitis with intraperitoneal moxifloxacin combined with dexamethasone was very effective in young rats without permanent bilateral carotid occlusion. The treatment reached reasonable results in older rats with PBCO, even considering residual abscesses on abdomen and thorax. Older age was the greater risk factor for the outcome of the treatment of severe peritonitis. Sepsis remains a challenging situation, especially in elderly.Key words: Peritonitis. Quinolones. Dexamethasone. Therapy. Rats. Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion.Response to intra peritoneal moxifloxacin combined with dexamethasone

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“…Of the four randomized controlled trials (conducted between 2000 and 2009), three were double-blind [13,[15][16] and one study was open-label [14]. All studies were designed to demonstrate the non-inferiority of moxifloxacin to comparator antibiotic regimens and used a non-inferiority margin of either 10% [13][14]16] or 15% [15].…”

Section: Design Of Studies Used In the Analysismentioning

confidence: 99%

“…All studies were designed to demonstrate the non-inferiority of moxifloxacin to comparator antibiotic regimens and used a non-inferiority margin of either 10% [13][14]16] or 15% [15]. All four studies were performed in accordance with the Declaration of Helsinki, the rules of International Conference on Harmonization (ICH) Good Clinical Practice and relevant national guidelines.…”

Section: Design Of Studies Used In the Analysismentioning

confidence: 99%

“…On the basis of pooled data from the four Phase III randomized, active-controlled, prospective clinical trials [13][14][15][16] comparing the efficacy and safety of moxifloxacin monotherapy with that of comparator regimens in mild-to-moderate cIAIs, we undertook a retrospective analysis of the efficacy and safety of moxifloxacin in this subgroup of patients with secondary peritonitis, reflecting an advanced form of peritonitis.…”

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confidence: 99%

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Efficacy and Safety of Moxifloxacin in Hospitalized Patients with Secondary Peritonitis: Pooled Analysis of Four Randomized Phase III Trials

Waele

Tellado²,

Weiß³

et al. 2014

Surgical Infections

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Background: Secondary peritonitis is an advanced form of complicated intra-abdominal infection (cIAI) requiring hospitalization, surgical source control, and empiric antibiotic therapy against causative aerobic and anaerobic bacteria.Methods: This pooled analysis of four prospective, active-controlled randomized clinical trials compared the efficacy and safety of moxifloxacin with that of comparator antibiotics in patients with confirmed secondary peritonitis. The primary efficacy endpoint was clinical success rate at test-of-cure (TOC) between day 10 and 45 post-therapy in the per-protocol (PP) population. Safety and clinical efficacy were assessed also in the intent-totreat population (ITT). Bacteriological success was assessed at TOC in the microbiologically-valid population as a secondary efficacy endpoint. Results: Overall clinical success rates at TOC were 85.3% (431 of 505 patients) in the moxifloxacin and 88.4% (459 of 519 patients) in the comparator treatment groups (PP population, point estimate for the difference in success rates: -3.0%; 95% CI -7.06%, 1.05%), respectively. Similar clinical success rates between moxifloxacin and comparators were observed by anatomical site of infection, and ranged from 80.6% to 100% for moxifloxacin and from 71.4% to 96.6% for comparators, respectively. Bacteriologic success rates were similar with moxifloxacin (82.4%) and comparators (86.8%), respectively. The proportion of patients experiencing any treatment-emergent adverse events was slightly higher with moxifloxacin (67.3%) versus comparators (59.8%). Rates of drug-related adverse events (20.9% versus 20.0%) and deaths (4.3% versus 3.4%) were similar in moxifloxacin and comparator groups; none of the deaths were drug-related. Conclusions: The data suggests that once-daily IV (or IV/PO) moxifloxacin has a comparable efficacy and safety profile to antibiotic regimens approved previously in the subgroup of patients with secondary peritonitis of mild-to-moderate severity.

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Moxifloxacin for the Treatment of Patients with Complicated Intra-abdominal Infections (the AIDA Study)

Cited by 44 publications

References 17 publications

Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy

Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy

Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion. Response to intra peritoneal moxifloxacin combined with dexamethasone

Efficacy and Safety of Moxifloxacin in Hospitalized Patients with Secondary Peritonitis: Pooled Analysis of Four Randomized Phase III Trials

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