Moxifloxacin associated with faster clinical recovery than levofloxacin in CAP treatment

A prospective, double-blind, randomized, controlled trial comparing the effectiveness of levofloxacin and moxifloxacin in treating community-acquired pneumonia (CAP) among 394 hospitalized elderly patients (aged 65 years and older) demonstrated that moxifloxacin resulted in faster recovery than levofloxacin.

The Community-Acquired Pneumonia Recovery in the Elderly (CAPRIE) study, published in the journal Clinical Infectious Diseases, also demonstrated that moxifloxacin was a more effective treatment for moderate and severe CAP in that age group.

"The CAPRIE study is very unique in that it was conducted only in patients 65 and older, such as the median age was 78," said Antonio Anzueto, MD, professor of medicine at the University of Texas Health Science Center and lead investigator.

Researchers measured patients' clinical response at a visit between the 5th and 21st days following the end of treament. Secondary end points measured patients' clinical response between the 3rd and 5th days of treatment and the bacteriologic response after the end of treatment.

For the primary end point, moxifloxacin cured 92.9% of the clinically valid patients while 87.9% of the levofloxacin group was cured (95% CI, –1.9 to 11.9; P=0.2). Between Days 3 and 5 of treatment, 97.9% of the moxifloxacin group was clinically recovered compared with 90% of the levofloxacin group (95% CI, 1.7–14.1; P=.01).

Moxifloxacin also was more efficacious in curing moderate (92.6%) and severe (94.7%) CAP than levofloxacin (88.6% and 84.6%, respectively, P=NS). Among patients aged 75 years and older, moxifloxacin cured 94.5% of patients compared with 90% of patients in the levofloxacin group (P=NS). Among those aged younger than 75 years, moxifloxacin cured 90% of patients compared with levofloxacin's 85% cure rate (P=NS).

SOURCE Anzueto A, Niederman MS, Pearle J, Restrepo MI, Heyder A, Choudhri SH; for the Community-Acquired Pneumonia Recovery in the Elderly Study Group. Community-acquired pneumonia recovery in the elderly (CAPRIE): Efficacy and safety of moxifloxacin therapy versus that of levofloxacin therapy. Clin Infect Dis. 2006;42:73–81.