Pharmacokinetics and peritoneal penetration of moxifloxacin in peritonitis

Staß, Heino; Rink, Andreas D.; Delesen, Heinz; Kubitza, Dagmar; Vestweber, K. H.

doi:10.1093/jac/dkl305

Cited by 42 publications

(29 citation statements)

References 10 publications

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“…Moxifloxacin penetrates well into normal gastrointestinal tissues [4,5] and diseased areas such as abdominal abscesses [1,6] and peritoneal exudate in patients with peritonitis [7].…”

Section: Introductionmentioning

confidence: 99%

Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Solomkin

Zhao

et al. 2009

International Journal of Antimicrobial Agents

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“…Moxifloxacin penetrates well into normal gastrointestinal tissues [4,5] and diseased areas such as abdominal abscesses [1,6] and peritoneal exudate in patients with peritonitis [7].…”

Section: Introductionmentioning

confidence: 99%

Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Solomkin

Zhao

et al. 2009

International Journal of Antimicrobial Agents

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“…Furthermore, broad-spectrum antibiotic therapy against causative bacteria is essential [1]. Moxifloxacin, a fluoroquinolone with good in vitro activity against most causative organisms in cIAIs [2,3], penetrates well into inflamed gastrointestinal tissues [4][5][6][7] and is a reliable treatment option for cIAIs [8][9][10]. Ertapenem is also active against a range of intraabdominal pathogens [11] and has demonstrated clinical efficacy in cIAIs [12,13].…”

mentioning

confidence: 99%

Randomised clinical trial of moxifloxacin versus ertapenem in complicated intra-abdominal infections: results of the PROMISE study

Waele

Tellado

Alder

et al. 2013

International Journal of Antimicrobial Agents

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Antibiotic therapy for complicated intra-abdominal infections (cIAIs) should provide broad-spectrum coverage both Gram-positive and Gram-negative microorganisms. The PROMISE study compared the clinical and bacteriological efficacy and safety of moxifloxacin versus ertapenem for the treatment of cIAIs. This randomised, prospective, double-dummy, double-blind, multicentre trial was designed as a non-inferiority study. The safety and efficacy of 5-14 days of daily intravenous moxifloxacin (400mg) or ertapenem (1g) were compared in patients with cIAIs requiring surgery and parenteral antibiotic therapy. The primary and secondary endpoints included clinical and bacteriological responses at 21-28 days after the end of treatment (TOC), respectively. Of 830 enrolled patients, 699 were efficacy valid. Moxifloxacin was non-inferior to ertapenem regarding clinical success [89.5% (315/352) versus 93.4% (324/347); 95% confidence interval (CI) -7.9%, 0.4%]. There were no significant differences between groups for any of the primary causes or types of cIAI regarding clinical response. Bacteriological success was achieved in 86.5% (257/297) of moxifloxacin-treated patients and 90.2% (249/276) of ertapenem-treated patients (95% CI -9.0%, 1.5%). There were no major differences between groups regarding the frequency or types of organisms eradicated. The incidence of adverse events (AEs) was higher with moxifloxacin than ertapenem (P=0.039), however a similar number of drug-related AEs was seen in each group (P=1.000). Wound infections, nausea and increased lipase were the most commonly reported AEs with both agents. The results show that moxifloxacin is a valuable treatment option for a range of community-acquired cIAIs with mild-to-moderate severity.

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“…This underlines the results of clinical studies showing an advantage of gatifloxacin in the treatment of uncomplicated skin and soft tissue infections (Tarshis et al, 2001). Moxifloxacin reaches almost the same concentration in peritoneal exudate and plasmal blood within 2 h after intravenous application: 3.61 mg ml 21 in plasma after 1 h versus 3.32 mg ml 21 in peritoneal exudate after 2 h (Stass et al, 2006). Since we have used serum C max concentrations in previous studies (Schaumann et al, 2004(Schaumann et al, , 2005a these concentrations were also used in the present study, resulting in a better in vitro activity of moxifloxacin compared to levofloxacin or gatifloxacin against the anaerobes tested here.…”

Section: Discussionmentioning

confidence: 97%

In vitro activities of levofloxacin, gatifloxacin, moxifloxacin and garenoxacin against Bacteroides fragilis strains evaluated by kill kinetics

Schaumann

Janssen

Funke

et al. 2013

Journal of Medical Microbiology

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This study was designed to investigate the killing activity of levofloxacin, gatifloxacin, moxifloxacin and garenoxacin against 12 Bacteroides fragilis strains by kill kinetics over time. MIC values were determined by Etest and by agar dilution. B. fragilis strains were divided according to their MIC values into two groups: one group with strains with MIC ,8.0 mg ml "1 and one group with strains with MIC ¢8.0 mg ml "1 . For kill kinetics over time, the strains with MIC ,8.0 mg ml "1 were incubated with the antibiotics at 0.5, 1, 2 and 4 times their MIC values. The strains with MIC ¢8.0 mg ml "1 were incubated with 0.5, 1, 2, and 4 times the maximum achievable concentrations of the antibiotics in human plasma (C max ). Among the strains with MIC ,8.0 mg ml "1 levofloxacin and gatifloxacin showed equal efficacy. The growth of the strains with MIC ¢8.0 mg ml "1 was barely affected by levofloxacin, while gatifloxacin had bactericidal action when concentrations of 4¾C max were used. Moxifloxacin was more effective against both groups of strains compared with levofloxacin and gatifloxacin. Garenoxacin was the most active agent against all strains investigated. Due to the varying in vitro activity of the quinolones against obligate anaerobes the treatment with quinolones of patients with intra-abdominal infections needs intensive scrutiny. INTRODUCTIONBacteroides fragilis is the most commonly isolated anaerobic pathogen (Wexler, 2007 2006). However, the problem of increasing resistance rates also applies to quinolones. Golan et al. (2003) found that quinolone resistance has been increasing among Bacteroides since 1994. Recently, Nagy et al. (2011) reported a dramatic increase in resistance to cefoxitin, clindamycin and moxifloxacin, with resistance rates of 17.2 %, 32.4 % and 13.6 %, respectively, throughout Europe, with higher resistance rates for moxifloxacin in Scandinavian countries than in Mediterranean countries (Fille et al., 2006;Hedberg et al., 2003). Thus, the knowledge of resistance patterns is important for adequate prophylaxis and treatment of anaerobic or mixed aerobic and anaerobic infections. As studies employing kill kinetics are expensive in terms of time and cost, they are not likely to be performed in the routine laboratory. Therefore, the aim of the present study was to investigate the in vitro killing activity of four different quinolones against 12 B. fragilis strains evaluated by kill kinetics over time. METHODSBacterial strains. Twelve B. fragilis isolates were selected from the institute's stock. The RMA strains were kindly provided by E. J. C. Goldstein, R. M. Alden Research Lab, Culver City, California, USA.3These authors contributed equally to this work. The WAL strains were collected at the University Hospital of Wales, Cardiff, UK, and are isolates of an international anaerobe study tested

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Pharmacokinetics and peritoneal penetration of moxifloxacin in peritonitis

Cited by 42 publications

References 10 publications

Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Randomised clinical trial of moxifloxacin versus ertapenem in complicated intra-abdominal infections: results of the PROMISE study

In vitro activities of levofloxacin, gatifloxacin, moxifloxacin and garenoxacin against Bacteroides fragilis strains evaluated by kill kinetics

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