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Oral Moxifloxacin vs High-Dosage Amoxicillin in the Treatment of Mild-To-Moderate, Community-Acquired, Suspected Pneumococcal Pneumonia in Adults

Oral Moxifloxacin vs High-Dosage Amoxicillin in the Treatment of Mild-To-Moderate, Community-Acquired, Suspected Pneumococcal Pneumonia in Adults

P Petitpretz, P Arvis, M Marel, J Moita, J Urueta, CAP5 Moxifloxacin Study Group

Chest. 2001 Jan;119(1):185-95.

PMID: 11157603

Abstract:

Study objectives:
Comparison of the efficacy and safety of moxifloxacin vs amoxicillin for treatment of mild-to-moderate, suspected pneumococcal community-acquired pneumonia (CAP) in adult patients.
Design:
Multinational, multicenter, double-blind, randomized study.
Setting:
Eighty-two centers in 20 countries (Argentina, Brazil, Chile, Croatia, Czech Republic, Estonia, France, Hong Kong, Hungary, Lithuania, Mexico, Portugal, Russia, Slovenia, South Africa, Spain, Turkey, Ukraine, United Kingdom, and Uruguay).
Patients:
Four hundred eleven adults (inpatients or outpatients) with suspected pneumococcal CAP.
Interventions:
Randomization 1:1 to moxifloxacin, 400 mg/d, or amoxicillin, 1,000 g tid, for 10 days.
Results:
Primary efficacy parameter was clinical response, 3 to 5 days after therapy (end of therapy [EOT]) in the per protocol (PP) population (362 patients). The clinical success rate in the PP population was 91.5% (moxifloxacin) and 89.7% (amoxicillin; two-sided 95% confidence interval, -4.2 to 7.8%). The clinical cure rate in patients with proven pneumococcal pneumonia was similar in both treatment groups (87.8%). The bacteriologic success rate in 136 bacteriologically evaluable patients at the EOT was 89.7% (moxifloxacin) and 82.4% (amoxicillin). The bacteriologic success rate against Streptococcus pneumoniae was 89.6% (moxifloxacin) and 84.8% (amoxicillin). The frequency of adverse events was comparable in both treatment groups. Digestive symptoms were the most common drug-related adverse events in both treatment groups.
Conclusions:
Moxifloxacin was statistically at least as effective as high-dose amoxicillin for treatment of mild-to-moderate, suspected pneumococcal CAP. Moxifloxacin may be an alternative for empiric CAP treatment, especially in areas where multidrug resistance in S pneumoniae is sufficiently prevalent to preclude routine penicillin.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP1029364779	Moxifloxacin Related Compound D		1029364-77-9	Price
AP1642559714	Amoxicillin Related Compound D		1642559-71-4	Price

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