Higgins K, Singer M, Valappil T, Nambiar S, Lin D, Cox E
US Food and Drug Administration, Center for Drug Evaluation and Research, Silver Spring, Maryland 20993, USA.
Clin Infect Dis. 2008 Dec 1;47 Suppl 3:S150-6. doi: 10.1086/591397.
All recent studies of antibacterial drugs for the indication of community-acquired pneumonia submitted to the US Food and Drug Administration have been designed as noninferiority studies. We provide a summary of results of 7 recent clinical studies of oral antibacterial drugs for treatment of community-acquired pneumonia. In these 7 studies, the majority of patients enrolled had Pneumonia Patient Outcomes Research Team scores of I or II. The percentage of randomized subjects with pathogens identified at baseline ranged from 47% to 76%, and the percentage of subjects with Streptoccocus pneumoniae isolated at baseline ranged from approximately 6% to 20%. The primary end point in these studies was clinical cure, assessed 7-21 days after completion of therapy. Clinical cure rates were >80% in the intent-to-treat populations and >90% in the per-protocol populations. We also briefly summarize the results from several recently submitted clinical studies of intravenously administered antibacterial drugs for treatment of community-acquired pneumonia, in which we found similar results.
所有提交给美国食品药品监督管理局的、以社区获得性肺炎为适应症的抗菌药物近期研究均设计为非劣效性研究。我们总结了7项近期关于口服抗菌药物治疗社区获得性肺炎的临床研究结果。在这7项研究中,大多数入组患者的肺炎患者预后研究团队评分为I级或II级。基线时确定有病原体的随机受试者百分比为47%至76%,基线时分离出肺炎链球菌的受试者百分比约为6%至20%。这些研究的主要终点是临床治愈,在治疗完成后7至21天进行评估。在意向性治疗人群中临床治愈率>80%,在符合方案人群中>90%。我们还简要总结了几项近期提交的关于静脉注射抗菌药物治疗社区获得性肺炎的临床研究结果,我们在这些研究中发现了类似的结果。