Moxifloxacin monotherapy versus β-lactam-based standard therapy for community-acquired pneumonia: a meta-analysis of randomised controlled trials

Abstract 

The aim of this study was to compare more conclusively the efficacy and safety of moxifloxacin, a new respiratory fluoroquinolone antibiotic, with β-lactam-based standard therapy, which has been reported to possess good efficacy for community-acquired pneumonia (CAP). A meta-analysis of randomised controlled trials (RCTs) identified in PubMed, the Cochrane Library and Embase was performed. Seven RCTs, involving 3903 patients, were included in the meta-analysis. Moxifloxacin monotherapy was associated with similar clinical treatment success rates [clinically evaluable population, odds ratio (OR)=1.15, 95% confidence interval (CI) 0.81–1.64; intention-to-treat population, OR=1.11, 95% CI 0.86–1.42] and similar mortality (OR=0.98, 95% CI 0.66–1.46) compared with β-lactam-based standard therapy for CAP. Microbiological treatment success rates in the moxifloxacin group were significantly higher than in the β-lactam-based therapy group with a statistical margin (OR=1.69, 95% CI 1.02–2.80). No difference was found regarding the incidence of adverse events and serious adverse events between moxifloxacin and β-lactam-based standard therapy. This meta-analysis provides evidence that moxifloxacin not only can be used as effectively and safely as β-lactam-based standard therapy for CAP but also possesses a favourable pathogen eradication rate. The once-daily dosing of moxifloxacin monotherapy may be a useful alternative for β-lactam-based standard therapy.

Keywords: Moxifloxacin, β-Lactams, Community-acquired pneumonia, Meta-analysis