Treatment Outcomes in Acute Exacerbations of Chronic Bronchitis: Comparison of Macrolides and Moxifloxacin from the Patient Perspective

Abstract

Moxifloxacin, a new respiratory quinolone, was compared with the macrolides azithromycin, clarithromycin and roxithromycin in a cohort study to assess clinical, safety and health-related outcomes of these antimicrobials in general practice settings. In total 332 patients with acute exacerbations of chronic bronchitis (AECB) each received one of the antimicrobial agents for a standard short course of therapy. Random allocation of therapeutic agents occurred by centre, not individuals, and the drugs were prescribed in an open manner. In addition to clinical evaluation by their physicians, all patients kept daily diaries to assess AECB symptoms over the study period, therapy received and quality of life. The overall clinical response rate was 96% and all four regimens were well tolerated. After 14 days there were no significant differences between the study groups, but analyses of patients' daily evaluations of certain AECB specific symptoms showed a faster response rate in the moxifloxacin group.

Guidelines for the management of adult lower respiratory tract infections

“…Levofloxacin and moxifloxacin are active against most of the strains of S. pneumoniae and H. influenzae and achieve high concentrations in bronchial secretions several times higher than the required MIC to treat these microorganisms [215][216][217][218][219]. In addition, they are active against Gram negative bacilli other than P. aeruginosa.…”

The quality of life impact of acute exacerbations of chronic bronchitis (AECB): A literature review

“…Four studies assessing pharmacological treatment and HRQL at two or more time points during an AECB and recovery period were identified [13,14,18,19]. In general, it appears that treatment is superior to no treatment, but there is little to recommend one treatment over another based on the instruments and duration of the studies identified here.…”

“…Two studies were double-blind and randomized [13,14]; six others were randomized, but not blinded (often necessary because of the nature of intervention) [15][16][17][18][19][20]. One randomized study of pharmacological interventions was not randomized by patient, but rather by site [19].…”

Moxifloxacina: profilo farmacologico, terapeutico e farmacoeconomico

“…L'efficacia clinica e la tollerabilità della moxifloxacina nella CAP, nelle AECB e nelle ABS sono state studiate su un numero elevato di pazienti, nel corso di diversi trial multicentrici controllati, nazionali e internazionali, strutturati nella maggior parte come studi in doppio cieco [101][102][103][104][105][106][107][108][109][110][111][112][113][114][115][116][117][118].…”

“…L'efficacia e l'utilità cliniche della moxifloxacina nelle bronchiti croniche riacutizzate sono state confermate da alcuni studi condotti in aperto [112][113][114].…”