To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: DG DISPATCH - ATS: Moxifloxacin Offers Promise of Combating Antimicrobial Resistance URL: http://www.pslgroup.com/dg/1D136E.htm Doctor's Guide May 11, 2000
By Cameron Johnston Special to DG News
TORONTO, ONTARIO -- May 11, 2000 -- Moxifloxacin (Avelox, Bayer) might prove to be an important weapon in the treatment of more serious, and contagious illnesses like tuberculosis.
Moxifloxacin, approved in the United States for the treatment of common respiratory tract infections, belongs to the first new class of drugs to be developed for treating such infections in more than 30 years. It comes at a time when resistance to other, more commonly used antibiotics such as erythromycin, ciprofloxacin and penicillin is reaching near-crisis proportions in some parts of the world.
In a presentation at this year's annual meeting of the American Thoracic Society, in Toronto, Canada, investigators from Westbank Research Center, a private drug investigating laboratory in Gretna, LA, said moxifloxacin was as effective over a five-day course of therapy as azithromycin.
The drug, according to lead investigator C. Andrew DeAbate, MD, was able to eradicate acute bacterial infections that cause exacerbations of chronic bronchitis in 63 per cent of patients tested within three days of initiating therapy. By comparison, azithromycin eradicated the pathogens in 48 per cent of patients.
Moxifloxacin's more rapid action could make it a logical choice for treating symptoms of acute bacterial exacerbation of chronic bronchitis (ABECB) because the condition has a high mortality rate. An important consideration for the drug is that, to date, no organisms have been shown to be resistant to it, whereas with azithromycin the rate of resistance is conservatively given as 14 per cent -- and higher in some areas of the US Europe and the rest of the world.
"Mocifloxacin seems to eradicate causative pathogens more rapidly than azithromycin," Dr. DeAbate said.
The study looked at 567 adult patients with suspected exacerbation of chronic bronchitis in the US and Canada. There were 221 in the study group and 243 in the azithromycin placebo group. Patients received five days of either moxifloxacin (400 mg once daily) or azithromycin (500 mg day one, followed by 250 mg for the next four days)
The success or failure of the therapy was based on total clearing up of symptoms in a clinical exam. Both groups of patients experienced similar rates of clearing -- 90 per cent for the study group versus 92 per cent of the placebo group.
Moxifloxacin successfully eradicated the most commonly isolated pathogens including H influenza, M. catarrhalis, S. pneumoniae, H parainfluenza and S aureus.
And while the drug has been approved in the US for treatment of certain common respiratory tract infections, it could have a useful role in treating tuberculosis, as well.
Richard O'Brien, MD, of the Center for Disease Control in Atlanta said moxifloxacin could represent one of a few new treatment regimens for TB. This, he said, is an important consideration, given the increasing number of cases of TB that are materializing in the developed world, and the fact that investigators are actively searching for new drugs that will augment the currently used therapies used to treat TB.
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