Clinical efficacy and safety of moxifloxacin versus levofloxacin plus metronidazole for community-acquired pneumonia with aspiration factors

• DOI: 10.3760/cma.j.issn.0366-6999.20131635
• Publication Date: 2024-01-16T18:58:38Z
• Authors: Tieying Sun; Li Sun; Rongmei Wang; Xiaoping Ren; Dong-jiang Sui; Chun Pu; Yajuan Ren; Ying Liu; Zhuo Yang; Fengzhi Li
• Keywords: Aged, 80 and over; Male; Moxifloxacin; Levofloxacin; Pneumonia; Middle Aged; Anti-Bacterial Agents; Community-Acquired Infections; 03 medical and health sciences; 0302 clinical medicine; Metronidazole; Humans; Female; Prospective Studies; Aged; Fluoroquinolones

Background Community-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.

Methods In this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.

Results Seven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (○2=4.002, P <0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P >0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P >0.05). No serious adverse events were observed.

Conclusions Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.