Trovafloxacin versus high-dose amoxicillin (1 g three times daily) in the treatment of community-acquired bacterial pneumonia

Abstract

Once-daily trovafloxacin 200 mg was compared with high-dose amoxicillin, 1 g three times daily, given for 7 to 10 days. At end of treatment (day 10), the response was clinically successful (cure + improvement) in 93% of 152 clinically evaluable trovafloxacin patients and in 89% of 160 amoxicillin patients. At study end (day 35), respective rates were 91% and 81% (95% confidence interval: 1.6, 17.6; P=0.01). In evaluable patients with positive baseline radiographs, 93% of trovafloxacin and 88% of amoxicillin patients demonstrated radiological resolution at end of treatment. Streptococcus pneumoniae and Haemophilus influenzae eradication rates were comparable at end of treatment in both treatment groups, but at study end Streptococcus pneumoniae eradication rates were higher in trovafloxacin patients (100% vs 81%). At study end, all four trovafloxacin patients with baseline penicillin-resistant Streptococcus pneumoniae were clinically cured with pathogen eradication, whereas two of five amoxicillin patients with baseline penicillin-resistant Streptococcus pneumoniae were clinical failures with pathogen persistence. For patients in whom no pathogen was identified, trovafloxacin was significantly more effective at end of treatment (P=0.096) and study end (P=0.013). Treatment-related adverse events were comparable; the most common were headache, vomiting and dizziness in trovafloxacin patients, and diarrhoea. headache and abdominal pain in amoxicillin patients.

Effectiveness of β lactam antibiotics compared with antibiotics active against atypical pathogens in non-severe community acquired pneumonia: meta-analysis

“…We identified 20 studies that met our inclusion criteria 11 – 26. Four of the studies (30% of participants) were unpublished as at November 2004 and were obtained from the sponsoring pharmaceutical companies either directly or secondary to the finding of a conference proceedings (see bmj.com).…”

Effectiveness of oral moxifloxacin in standard first-line therapy in community-acquired pneumonia

“…These included the clinical response at days 3-5 (on treatment) and days [28][29][30][31][32][33][34][35] (after the end of the treatment), the CAP symptom score (derived from the validation statistical analysis) [15], the SF-36 scores (calculated according to the recommended algorithms) [17], and healthcare utilisation data reported in units consumed without direct economic valuation.…”

“…New fluoroquinolones in monotherapy, such as moxifloxacin, gatifloxacin or levofloxacin, have been suggested as first-line antibiotics in CAP. Several studies have compared new fluoroquinolones with amoxicillin [28][29][30][31] or with second-and thirdgeneration cephalosporin [32][33][34][35] or macrolide, such as clarithromycin [36][37][38][39][40][41]. However, no single study has embraced all of the therapeutically recognised options in CAP in an effectiveness analysis like that conducted in the present investigation.…”

Diez respuestas puntuales sobre neumonía adquirida en la comunidad en adultos

“…Otras guías recomiendan Iniciar dentro de las primeras 8 horas posteriores al diagnóstico. (Nivel de evidencia II -Grado de recomendación B) (23,25,26,27,28,29,30,31,51).…”