Wadi Al Ramahi Jamal, Ramadan Mustafa, Jaber Waad, Abushanab Lamya, Mughrabi Mohammad, Alshamayleh Noor, Mulhem Ahmad, Momani Dania, Obaidat Mohammad, Haddad Ghayda, Khalil Basma, Zahran Anas, Odat Esraa, Kufoof Nadeen, Arabiat Haneen, Diab Amr, Anzueto Antonio
Al Khalidi Hospital and Medical Center. Amman, Jordan.
Al Takhassusi Hospital, Amman, Jordan.
J Infect Dev Ctries. 2018 Oct 31;12(10):878-886. doi: 10.3855/jidc.10335.
To evaluate the speed of recovery in CAP-treated adults with Moxifloxacin versus levofloxacin.
A retrospective multicenter study between January 14, 2010 - March 23, 2017. Patients' records with the diagnosis of community-acquired pneumonia (CAP), age ≥ 18 and ≤ 60 years old, susceptible bacteria to the prescribed fluoroquinolone, completed three days of antimicrobial therapy and who were switched from parenteral to the oral form for the same antimicrobial agent were included.
701 charts were reviewed, 367 were excluded; not on respiratory fluoroquinolones (RFQ), age > 60 or < 18 years old, not enough data, prior antimicrobials, hospital-associated pneumonia, < 3 days of therapy, and one pregnant woman. 334 patients were Included; 167 levofloxacin and 167 moxifloxacin, with 68.5% males (P = 0.259), no significant difference in comorbidities (P > .05), but increased diabetes mellitus in moxifloxacin-treated patients (P = 0.012). No significant difference in Pneumonia Severity Index (PSI). Multivariate and univariate analysis demonstrated that day 3 rate of improvement; levofloxacin-treated patients 75.9% (95% CI, 69.9 to 81.8), and 84.0% (95% CI, 78.1 to 89.9) for Moxifloxacin (difference -8.1%, 95% CI, -16.5 - .003, P = 0.058). And day 5 rates of improvement in Levofloxacin-treated patients was 91.9%, (95% CI, 88.3 - 95.6), and 95.5% (95% CI, 91.8 - 99.2) for moxifloxacin (difference -3.5%, 95% CI, -8.7 - 1.7, P = 0.184). There was no significant difference for patients with radiological diagnoses for day 3 (P = 0.832) and 5 (P = 0.929).
Our uni-and-multivariate analyses demonstrated that moxifloxacin exhibited no significant differences in the rates of improvement on days 3 and 5.
评估莫西沙星与左氧氟沙星治疗社区获得性肺炎(CAP)成人患者的恢复速度。
一项回顾性多中心研究,时间跨度为2010年1月14日至2017年3月23日。纳入诊断为社区获得性肺炎(CAP)、年龄≥18岁且≤60岁、对处方氟喹诺酮敏感的细菌、完成三天抗菌治疗且从静脉给药转换为相同抗菌药物口服给药的患者记录。
共审查701份病历,排除367份;排除标准包括未使用呼吸氟喹诺酮类(RFQ)、年龄>60岁或<18岁、数据不足、曾使用过抗菌药物、医院相关性肺炎、治疗时间<3天以及1名孕妇。纳入334例患者;其中167例使用左氧氟沙星,167例使用莫西沙星,男性占68.5%(P = 0.259),合并症无显著差异(P>.05),但莫西沙星治疗患者的糖尿病发生率有所增加(P = 0.012)。肺炎严重程度指数(PSI)无显著差异。多因素和单因素分析表明,第3天的改善率;左氧氟沙星治疗患者为75.9%(95%CI,69.9至81.8),莫西沙星治疗患者为84.0%(95%CI,78.1至89.9)(差异-8.1%,95%CI,-16.5至0.003,P = 0.058)。左氧氟沙星治疗患者第5天的改善率为91.9%(95%CI,88.3至95.6),莫西沙星治疗患者为95.5%(95%CI,91.8至99.2)(差异-3.5%,95%CI,-8.7至1.7,P = 0.184)。第3天(P = 0.832)和第5天(P = 0.929)影像学诊断的患者无显著差异。
我们的单因素和多因素分析表明,莫西沙星在第3天和第5天的改善率上无显著差异。