Keating Karen N, Friedman Howard S, Perfetto Eleanor M
Bayer Pharmaceuticals Corp., West Haven, CT 06516, USA.
Curr Med Res Opin. 2006 Feb;22(2):327-33. doi: 10.1185/030079906X80620.
Antibiotics are clinically indicated for acute bacterial rhinosinusitis, but they may be prescribed inappropriately. This retrospective study examined how labeled recommendations for duration of moxifloxacin and levofloxacin treatment of acute bacterial rhinosinusitis compare with real-world practice, and compared the failure and recurrence rates, and associated charges.
The PharMetrics Patient-Centric claims database was searched over a 3-year period for episodes of acute rhinosinusitis treated within 5 days with moxifloxacin or levofloxacin. The duration of antibiotic treatment prescribed was compared with the labeled recommendation. Failure rates (a second antibiotic claim to treat acute rhinosinusitis within 30 days of the first claim), recurrence rates (subsequent antibiotic claims to treat any rhinosinusitis more than 30 days after the original or second [in the case of failure] claim), and treatment charges from the perspective of the payer (health insurer) were also compared using multivariate analysis.
The initial duration prescribed of moxifloxacin was shorter than for levofloxacin (-1.65 days, p < 0.0001), reflecting the shorter labeled recommendation (10 days versus 10-14 days). The durations of monotherapy (-2.06 days, p < 0.0001) and of all antibiotic treatment (-1.97 days, p < 0.0001) were also significantly shorter for episodes treated initially with moxifloxacin. The odds ratio for treatment failure (0.718; 95% confidence interval = 0.598-0.863; p = 0.0004) and the hazard ratio for recurrence (0.652; p = 0.0005) were both significantly lower for moxifloxacin than for levofloxacin, and resulted in lower total treatment charges (-$37.94 +/- 13.65; p = 0.0055).
The shorter treatment durations seen for moxifloxacin in this database of real-world care reflect the label-recommended duration for acute rhinosinusitis. Despite this shorter duration of therapy, moxifloxacin resulted in better outcomes than levofloxacin in terms of the risk of treatment failure and recurrence. In addition, the total charges were lower for patients treated with moxifloxacin.
抗生素在临床上用于治疗急性细菌性鼻窦炎，但可能存在不合理使用的情况。这项回顾性研究探讨了莫西沙星和左氧氟沙星治疗急性细菌性鼻窦炎的标注疗程建议与实际临床应用情况的对比，同时比较了治疗失败率、复发率及相关费用。
在PharMetrics以患者为中心的索赔数据库中，检索3年内使用莫西沙星或左氧氟沙星在5天内治疗急性鼻窦炎的病例。将抗生素治疗的规定疗程与标注建议进行比较。使用多变量分析比较治疗失败率（首次索赔后30天内再次使用抗生素治疗急性鼻窦炎）、复发率（首次或第二次[治疗失败时]索赔后30天以上后续使用抗生素治疗任何鼻窦炎）以及从支付方（健康保险公司）角度的治疗费用。
莫西沙星的初始规定疗程比左氧氟沙星短（-1.65天，p<0.0001），这反映了其标注的疗程建议较短（10天对比10 - 14天）。对于最初用莫西沙星治疗的病例，单药治疗疗程（-2.06天，p<0.
