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Community acquired pneumonia-moxifloxacin: a prospective randomized trial

The objective of a prospective multicenter randomized trial was to compare the efficacy and safety of monotherapy with community-acquired pneumonia with moxifloxacin (400 mg once daily) compared to a combination therapy with ceftriaxone (2 g once a day iv) and levofloxacin (first iv, then inside 500 mg 2 times a day); both types of treatment were prescribed for 7-14 days.

The study involved 733 patients (368 people in the moxifloxacin group and 365 patients in the combination therapy group) aged over 18, hospitalized for community-acquired pneumonia and belonging to class III-V when they were evaluated on a PSI scale.

As the main final criterion for evaluating the efficacy of the treatment, the clinical response to the treatment at the time of the evaluation of the cure was taken into account (4-14 days after the end of the treatment); the final secondary criteria for evaluating efficacy were the clinical and bacteriological response at the end of treatment (7-14 days) and evaluation at the follow-up visit (21-28 days after treatment).

Among the 569 patients (291 people in the moxifloxacin group and 278 patients in the ceftriaxone + levofloxacin group) who were adapted to the analysis according to the protocol, the overall clinical cure rate during the healing visit was 86.9% in the moxifloxacin group and 89.9% - in the comparison group. The bacteriological efficacy of the treatment was 83.3% and 85.1% respectively. During the study, there was no significant difference in the mortality rate and in the incidence of adverse events occurring during treatment between the groups compared.

Thus, the efficacy of monotherapy with moxifloxacin is not less than that of ceftriaxone with levofloxacin in adult patients hospitalized for community-acquired pneumonia.