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Oral Moxifloxacin as Effective as Intramuscular Ceftriaxone: Presented at ERS

By Cameron Johnston
Special to DG News

STOCKHOLM, SWEDEN -- September 24, 2002 -- A five-day oral formulation of moxifloxacin has been shown in a large Italian multicentre study to be at least as effective as a seven-day course of intramusclar ceftriaxone in treating patients with acute exacerbations of chronic bronchitis.

The study results were presented here at the annual meeting of the European Respiratory Society (ERS) by Dr. C. Grassi, of the University of Pavia, in Italy

The study included 423 subjects with a mean age of 69 years, who were randomised to receive either moxifloxacin 400 mg/day once daily, or ceftriaxone 1g once daily intramuscularly for seven days.

In the study, 67 to 70 percent of the patients were hospitalised, and were considered "quite sick" the investigators said, noting that the subjects had had chronic bronchitis for a mean duration of 13.5 years. One in five reported a near continuous coughing while 70 percent said their coughing occurred mostly during the day.

Patients were evaluated at the end of the treatment period with each drug, and then 10 days after that, as well as again at six months follow-up.

A clinical response rate was seen in 95.3 percent of those in the moxifloxacin group and in 92.9 percent of those in the ceftriaxone group at the end of treatment. Ten days post-treatment, the response rates were statistically equivalent at 90.6 percent in the moxifloxacin-treated group and 89 percent in the ceftriaxone group.

As for bacteriological response, eradication was presumed in 57.9 percent of the moxifloxacin group and 56.8 percent of the ceftriaxone group. Eradication was confirmed in 34.2 and 37.8 percent of the two groups, respectively. Persistence and presumed persistence were seen in 2.6 percent of the moxifloxacin group and none in the ceftriaxone group.

Although the efficacy of the two drugs was more or less the same, the investigators noted that there was a substantial price differential in the moxifloxacin group. This was largely due to the shorter hospital stay for those in that group.

Also, over the longer term, there were fewer exacerbations in the six months following the study in the moxifloxacin arm compared with the ceftriaxone arm - an important consideration given that the subjects in the study experienced a mean of three episodes of acute exacerbations per year.

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