Efficacy and Tolerability of Moxifloxacin for Respiratory Tract Infections
Efficacy and Tolerability of Moxifloxacin for Respiratory Tract Infections
Objective: This study aimed to assess the efficacy, safety and tolerability of oral moxifloxacin in patients with respiratory tract infections (RTIs) treated by attending physicians in routine clinical practice in China.
Methods: This was an open-label, prospective, uncontrolled, post-marketing surveillance study that was undertaken between November 2002 and July 2003. Altogether, 855 patients with RTIs were treated with moxifloxacin. Data were collected by 257 physicians throughout China. Symptoms of RTI (fever, cough, purulent sputum, dyspnoea, thoracic pain, nasal obstruction, nasal secretion and headache), together with auscultatory findings, were assessed at baseline and at follow-up visits, and classified as 'absent', 'mild' or 'severe' by the attending physician.
Results: Moxifloxacin produced significant improvements in 70.7% of patients after only 3 days of treatment. In 91.7% of patients, symptoms were improved after 5 days of treatment; 76.1% of patients recovered after 7 days and 84.7% recovered after 10 days of treatment. The mean ± SD time until recovery was 5.1 ± 2.6 days. Assessment of treatment efficacy by the physicians was 'good' or 'very good' for 89.2% of patients. In 87.3% of cases, physicians rated patients' acceptance of therapy with moxifloxacin as 'good' or 'very good'. The tolerability of moxifloxacin therapy was rated as 'good' or 'very good' for 88.8% of patients. Very few adverse events (4.1% of patients) were reported with moxifloxacin; most of them involved mild CNS disorders and gastrointestinal disturbances.
Conclusions: Moxifloxacin was shown to be an effective and well tolerated treatment for this group of patients with RTIs and was highly rated by both physicians and patients because of rapid symptom improvement and good tolerability.
Acute respiratory tract infections (RTIs) are a common source of morbidity and mortality, and may be life-threatening, particularly in vulnerable groups such as the elderly. RTIs also account for around two-thirds of antibacterial prescriptions written for community-acquired infections. Therefore, they represent a huge economic burden for the healthcare system.
Community-acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB) and acute sinusitis are the most common RTIs. Current guidelines suggest that in patients with CAP, attempts should be made to determine the causative pathogens in order to optimise treatment. However, it is not possible to identify a specific aetiology in around half of all patients with CAP. Nevertheless, an effective therapy should be administered as early as possible to prevent the disease from becoming chronic and to avoid complications.Streptococcus pneumoniae is the most common pathogen for CAP, followed by Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, S. pyogenes and Klebsiella pneumoniae. Infection with 'atypical pathogens' such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila is also increasingly being reported. In acute bacterial sinusitis, the organisms most frequently isolated in samples obtained by sinus aspiration are S. pneumoniae (31%) and H. influenzae (21%). The aetiology of AECB is multifactorial, with bacterial infection suspected in 50% of cases.Empirical antibacterial therapy for these pathogens is usually indicated to avoid complications and to influence the course of disease.
Moxifloxacin is a novel 8-methoxy-fluoroquinolone with a broad spectrum of activity against commonly encountered respiratory tract pathogens. It has been shown to have rapid antibactericidal activity against both Gram-positive and Gram-negative organisms and a high degree of penetration into body tissues and fluids. Moxifloxacin is sensitive to penicillin- and macrolide-resistant strains of S. pneumoniae, β-lactamase-negative and -positive Haemophilus strains, as well as atypical pathogens. The main objective of the present post-marketing surveillance (PMS) study was to investigate the efficacy and tolerability of moxifloxacin in the treatment of RTIs.
Abstract and Introduction
Abstract
Objective: This study aimed to assess the efficacy, safety and tolerability of oral moxifloxacin in patients with respiratory tract infections (RTIs) treated by attending physicians in routine clinical practice in China.
Methods: This was an open-label, prospective, uncontrolled, post-marketing surveillance study that was undertaken between November 2002 and July 2003. Altogether, 855 patients with RTIs were treated with moxifloxacin. Data were collected by 257 physicians throughout China. Symptoms of RTI (fever, cough, purulent sputum, dyspnoea, thoracic pain, nasal obstruction, nasal secretion and headache), together with auscultatory findings, were assessed at baseline and at follow-up visits, and classified as 'absent', 'mild' or 'severe' by the attending physician.
Results: Moxifloxacin produced significant improvements in 70.7% of patients after only 3 days of treatment. In 91.7% of patients, symptoms were improved after 5 days of treatment; 76.1% of patients recovered after 7 days and 84.7% recovered after 10 days of treatment. The mean ± SD time until recovery was 5.1 ± 2.6 days. Assessment of treatment efficacy by the physicians was 'good' or 'very good' for 89.2% of patients. In 87.3% of cases, physicians rated patients' acceptance of therapy with moxifloxacin as 'good' or 'very good'. The tolerability of moxifloxacin therapy was rated as 'good' or 'very good' for 88.8% of patients. Very few adverse events (4.1% of patients) were reported with moxifloxacin; most of them involved mild CNS disorders and gastrointestinal disturbances.
Conclusions: Moxifloxacin was shown to be an effective and well tolerated treatment for this group of patients with RTIs and was highly rated by both physicians and patients because of rapid symptom improvement and good tolerability.
Introduction
Acute respiratory tract infections (RTIs) are a common source of morbidity and mortality, and may be life-threatening, particularly in vulnerable groups such as the elderly. RTIs also account for around two-thirds of antibacterial prescriptions written for community-acquired infections. Therefore, they represent a huge economic burden for the healthcare system.
Community-acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB) and acute sinusitis are the most common RTIs. Current guidelines suggest that in patients with CAP, attempts should be made to determine the causative pathogens in order to optimise treatment. However, it is not possible to identify a specific aetiology in around half of all patients with CAP. Nevertheless, an effective therapy should be administered as early as possible to prevent the disease from becoming chronic and to avoid complications.Streptococcus pneumoniae is the most common pathogen for CAP, followed by Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, S. pyogenes and Klebsiella pneumoniae. Infection with 'atypical pathogens' such as Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumophila is also increasingly being reported. In acute bacterial sinusitis, the organisms most frequently isolated in samples obtained by sinus aspiration are S. pneumoniae (31%) and H. influenzae (21%). The aetiology of AECB is multifactorial, with bacterial infection suspected in 50% of cases.Empirical antibacterial therapy for these pathogens is usually indicated to avoid complications and to influence the course of disease.
Moxifloxacin is a novel 8-methoxy-fluoroquinolone with a broad spectrum of activity against commonly encountered respiratory tract pathogens. It has been shown to have rapid antibactericidal activity against both Gram-positive and Gram-negative organisms and a high degree of penetration into body tissues and fluids. Moxifloxacin is sensitive to penicillin- and macrolide-resistant strains of S. pneumoniae, β-lactamase-negative and -positive Haemophilus strains, as well as atypical pathogens. The main objective of the present post-marketing surveillance (PMS) study was to investigate the efficacy and tolerability of moxifloxacin in the treatment of RTIs.
