International Journal of Antimicrobial Agents
Volume 36, Issue 1 , Pages 58-65 , July 2010

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

  • Mao Mao An

      Affiliations

    • R&D Center of New Drugs, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, PR China
    • These authors contributed equally to this paper.
    • ,
  • Zui Zou

      Affiliations

    • Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai 200433, PR China
    • These authors contributed equally to this paper.
    • ,
  • Hui Shen

      Affiliations

    • Chinese Academy of Medical Sciences, Peking Union Medical College, Fuwai Hospital & Cardiovascular Institute, 167 Beilishi Road, Beijing 100037, PR China
    • ,
  • Ping Hui Gao

      Affiliations

    • R&D Center of New Drugs, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, PR China
    • ,
  • Yong Bing Cao

      Affiliations

    • R&D Center of New Drugs, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, PR China
    • Corresponding Author InformationCorresponding author. Tel.: +86 21 8187 1275; fax: +86 21 6549 0641.
    • ,
  • Yuan Ying Jiang

      Affiliations

    • R&D Center of New Drugs, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, PR China
    • Corresponding Author InformationCorresponding author. Tel.: +86 21 8187 1357; fax: +86 21 6549 0641.

Received 8 February 2010 ,Accepted 4 March 2010.

References 

  1. Niederman MS, Mandell LA, Anzueto A, Bass JB, Broughton WA, Campbell GD, et al. Guidelines for the management of adults with community-acquired pneumonia. Am J Respir Crit Care Med. 2001;163:1730–1754
  2. Rello J, Catalán M, Díaz E, Bodí M, Alvarez B. Associations between empirical antimicrobial therapy at the hospital and mortality in patients with severe community-acquired pneumonia. Intensive Care Med. 2002;28:1030–1035
  3. Appelbaum PC. Resistance among Streptococcus pneumoniae: implications for drug selection. Clin Infect Dis. 2002;34:1613–1620
  4. Metlay JP. Update on community-acquired pneumonia: impact of antibiotic resistance on clinical outcomes. Curr Opin Infect Dis. 2002;15:163–167
  5. File TM. Appropriate use of antimicrobials for drug-resistant pneumonia: focus on the significance of β-lactam-resistant Streptococcus pneumoniae. Clin Infect Dis. 2002;34(Suppl. 1):S17–S26
  6. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl. 2):S27–S72
  7. Brueggemann AB, Kugler KC, Doern GV. In vitro activity of BAY 12-8039, a novel 8-methoxyquinolone, compared to activities of six fluoroquinolones against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Antimicrob Agents Chemother. 1997;41:1594–1597
  8. Jones ME, Staples AM, Critchley I, Thornsberry C, Heinze P, Engler HD, et al. Benchmarking the in vitro activities of moxifloxacin and comparator agents against recent respiratory isolates from 377 medical centers throughout the United States. Antimicrob Agents Chemother. 2000;44:2645–2652
  9. Blondeau J. A review of the comparative in vitro activities of 12 antimicrobial agents, with a focus on five new respiratory quinolones. J Antimicrob Chemother. 1999;43:1–11
  10. MacGowan AP, Bowker KE, Holt HA, Wootton M, Reeves DS. Bay 12-8039, a new 8-methoxy-quinolone: comparative in-vitro activity with nine other antimicrobials against anaerobic bacteria. J Antimicrob Chemother. 1997;40:503–509
  11. Nightingale CH. Moxifloxacin, a new antibiotic designed to treat community-acquired respiratory tract infections: a review of microbiologic and pharmacokinetic–pharmacodynamic characteristics. Pharmacotherapy. 2000;20:245–256
  12. Miravittles M. Moxifloxacin in respiratory tract infections. Expert Opin Pharmacother. 2005;6:283–293
  13. Bébéar CM, Renaudin H, Boudjadja A, Bébéar C. In vitro activity of BAY 12-8039, a new fluoroquinolone against mycoplasmas. Antimicrob Agents Chemother. 1998;42:703–704
  14. Roblin PM, Hammerschlag MR. In vitro activity of a new 8-methoxyquinolone, BAY 12-8039, against Chlamydia pneumoniae. Antimicrob Agents Chemother. 1998;42:951–952
  15. Ruckdeschel G, Dalhoff A. The in-vitro activity of moxifloxacin against Legionella species and the effects of medium on susceptibility test results. J Antimicrob Chemother. 1999;43(Suppl. B):25–29
  16. Boswell FJ, Andrews JM, Jevons G, Wise R. Comparison of the in vitro activities of several new fluoroquinolones against respiratory pathogens and their abilities to select fluoroquinolone resistance. J Antimicrob Chemother. 2002;50:495–502
  17. Finch R, Schürmann D, Collins O, Kubin R, McGivern J, Bobbaers H, et al. Randomized controlled trial of sequential intravenous (i.v.) and oral moxifloxacin compared with sequential i.v. and oral co-amoxiclav with or without clarithromycin in patients with community-acquired pneumonia requiring initial parenteral treatment. Antimicrob Agents Chemother. 2002;46:1746–1754
  18. Katz E, Larsen LS, Fogarty CM, Hamed K, Song J, Choudhri S. Safety and efficacy of sequential i.v. to p.o. moxifloxacin versus conventional combination therapies for the treatment of community-acquired pneumonia in patients requiring initial i.v. therapy. J Emerg Med. 2004;27:395–405
  19. Petitpretz P, Arvis P, Marel M, Moita J, Urueta J CAP5 Moxifloxacin Study Group. Oral moxifloxacin vs high-dosage amoxicillin in the treatment of mild-to-moderate, community-acquired, suspected pneumococcal pneumonia in adults. Chest. 2001;119:185–195
  20. Portier H, Brambilla C, Garre M, Paganin F, Poubeau P, Zuck P. Moxifloxacin monotherapy compared to amoxicillin–clavulanate plus roxithromycin for nonsevere community-acquired pneumonia in adults with risk factors. Eur J Clin Microbiol Infect Dis. 2005;24:367–376
  21. Torres A, Garau J, Arvis P, Carlet J, Choudhri S, Kureishi A, et al. Moxifloxacin monotherapy is effective in hospitalized patients with community-acquired pneumonia: the MOTIV study—a randomized clinical trial. Clin Infect Dis. 2008;46:1499–1509
  22. Welte T, Petermann W, Schürmann D, Bauer TT, Reimnitz P. Treatment with sequential intravenous or oral moxifloxacin was associated with faster clinical improvement than was standard therapy for hospitalized patients with community-acquired pneumonia who received initial parenteral therapy. Clin Infect Dis. 2005;41:1697–1705
  23. Xu S, Xiong S, Xu Y, Liu J, Liu H, Zhao J, et al. Efficacy and safety of intravenous moxifloxacin versus cefoperazone with azithromycin in the treatment of community acquired pneumonia. J Huazhong Univ Sci Technol Med Sci. 2006;26:421–424
  24. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996;17:1–12
  25. Khan KS, Daya S, Jadad A. The importance of quality of primary studies in producing unbiased systematic reviews. Arch Intern Med. 1996;156:661–666
  26. Moher D, Jadad AR, Tugwell P. Assessing the quality of randomized controlled trials. Current issues and future directions. Int J Technol Assess Health Care. 1996;12:195–208
  27. Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F. Methods for meta-analysis in medical research. Chichester, UK: Wiley; 2000;
  28. Vardakas KZ, Siempos II, Grammatikos A, Athanassa Z, Korbila IP, Falagas ME. Respiratory fluoroquinolones for the treatment of community-acquired pneumonia: a meta-analysis of randomized controlled trials. CMAJ. 2008;179:1269–1277
  29. Poole K. Mechanisms of bacterial biocide and antibiotic resistance. Symp Ser Soc Appl Microbiol. 2002;31(Suppl.):55S–64S
  30. Krasemann C, Meyer J, Tillotson G. Evaluation of the clinical microbiology profile of moxifloxacin. Clin Infect Dis. 2001;32(Suppl. 1):S51–S63
  31. Dalhoff A. Comparative in vitro and in vivo activity of the C-8 methoxy quinolone moxifloxacin and the C-8 chlorine quinolone BAY y 3118. Clin Infect Dis. 2001;32(Suppl. 1):S16–S22
  32. Drlica K, Zhao X. Mutant selection window hypothesis updated. Clin Infect Dis. 2007;44:681–688
  33. Blondeau JM, Zhao X, Hansen G, Drlica K. Mutant prevention concentrations of fluoroquinolones for clinical isolates of Streptococcus pneumoniae. Antimicrob Agents Chemother. 2001;45:433–438
  34. Hesje CK, Tillotson GS, Blondeau JM. MICs, MPDs and PK/PDs: a match (sometimes) made in hosts. Expert Rev Respir Med. 2007;1:7–16
  35. Simoens S. Evidence for moxifloxacin in community-acquired pneumonia: the impact of pharmaco-economic considerations on guidelines. Curr Med Res Opin. 2009;25:2447–2457
  36. Davis SL, Delgado G, McKinnon PS. Pharmacoeconomic considerations associated with the use of intravenous-to-oral moxifloxacin for community-acquired pneumonia. Clin Infect Dis. 2005;41(Suppl. 2):S136–S143
  37. Higgins J, Thompson S, Deeks J, Altman D. Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice. J Health Serv Res Policy. 2002;7:51–61
  38. Sterne JAC, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046–1055
  39. Lau J, Ioannidis JPA, Schmid CH. Summing up the evidence: one answer is not always enough. Lancet. 1997;351:123–127
  40. Thompson SG. Why sources of heterogeneity in meta-analysis should be investigated. BMJ. 1994;309:1351–1355

PII: S0924-8579(10)00133-0

doi: 10.1016/j.ijantimicag.2010.03.010

International Journal of Antimicrobial Agents
Volume 36, Issue 1 , Pages 58-65 , July 2010

Article Tools

* Image Usage & Resolution