MONTREAL — The potent respiratory fluoroquinolone moxifloxacin is as safe and effective as combination ampicillin/sulbactam therapy for the treatment of aspiration-associated pulmonary infections, Sebastian Ott, M.D., reported in a poster presentation at an international conference on community-acquired pneumonia.
To compare the efficacy, safety, and tolerability of moxifloxacin (Avelox) with that of ampicillin/sulbactam (Unasyn) for the treatment of aspiration pneumonia and primary lung abscess, Dr. Ott of the Helios Chest Hospital Heckeshorn in Berlin and his colleagues enrolled 139 patients diagnosed with either condition in a multicenter, open-label trial.
Nearly 65% of the patients in the study were diagnosed solely with aspiration pneumonia, and definite or presumptive pathogens were isolated in 45 subjects, he said.
Of the 139 patients, 96 were treated according to protocol: 48 were randomized to receive 400 mg of moxifloxacin given intravenously once daily followed by oral moxifloxacin for 7–14 days or until complete resolution of radiologic and clinical signs of infection, and 48 received 1.5–3.0 g of ampicillin/sulbactam intravenously twice daily followed by oral administration for the same duration.
At the end of treatment, the overall clinical response rate for both groups was 67%. In the moxifloxacin group, 59% of patients with aspiration pneumonia and 80% of those with primary lung abscess had responded to the antibiotic treatment.
Among those who received ampicillin/sulbactam, 64% of the aspiration pneumonia patients and 82% of the primary lung abscess patients responded to treatment.
Both of the regimens were well tolerated to a similar degree, “even after long-term administration,” Dr. Ott said. “The benefit of moxifloxacin is that its [once-daily] dosing is more convenient.”
The findings of this study provide clinicians with an important therapeutic option to add to their toolbox for treating aspiration-related pulmonary infections, which are rare but potentially life threatening.