Speed of recovery in adult patients with community-acquired pneumonia; moxifloxacin versus levofloxacin

Abstract

Introduction: To evaluate the speed of recovery in CAP-treated adults with Moxifloxacin versus levofloxacin. Methodology: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. Results: 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). Conclusions: Our uni-and-multivariate analyses demonstrated that moxifloxacin exhibited no significant differences in the rates of improvement on days 3 and 5.