MONTREAL — The potent respiratory fluoroquinolone moxifloxacin is as safe and effective as combination ampicillin/sulbactam therapy for the treatment of aspiration-associated pulmonary infections, Sebastian Ott, M.D., reported in a poster presentation at an international conference on community-acquired pneumonia.
To compare the efficacy, safety, and tolerability of moxifloxacin (Avelox) with that of ampicillin/sulbactam (Unasyn) for treating aspiration pneumonia and primary lung abscess, Dr. Ott of the Helios Chest Hospital Heckeshorn in Berlin and his colleagues enrolled 139 patients with either condition in a multicenter, open-label trial.
Nearly 65% of the patients were diagnosed solely with aspiration pneumonia, and definite or presumptive pathogens were isolated in 45 subjects, he said.
Of the 139 patients, 96 were treated according to protocol: 48 were randomized to 400 mg IV moxifloxacin once daily followed by oral moxifloxacin for 7–14 days or until complete resolution of radiologic and clinical signs of infection; 48 received 1.5–3.0 g IV ampicillin/sulbactam twice daily followed by oral administration for the same duration.
At the end of treatment, the overall clinical response rate for both groups was 67%. In the moxifloxacin group, 59% of patients with aspiration pneumonia and 80% of those with primary lung abscess responded to treatment. In the ampicillin/sulbactam group, 64% of the aspiration pneumonia patients and 82% of the primary lung abscess patients responded to treatment.
Both regimens were well tolerated to a similar degree, “even after long-term administration,” Dr. Ott said. “The benefit of moxifloxacin is that its [once-daily] dosing is more convenient.”
The findings provide clinicians with an important therapeutic option to add to their toolbox for treating aspiration-related pulmonary infections.
“There is limited information on optimal antibacterial therapeutic regimens for aspiration pneumonia and lung abscess patients. This study, which provides the biggest number of these patients published so far, indicates that moxifloxacin's activity against anaerobic bacteria is important and useful in treating these severe conditions,” he said.