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Infection Clinical and Epidemiological Study
Moxioxacin vs Ampicillin/Sulbactam in Aspiration Pneumonia and Primary Lung Abscess
S.R. Ott, M. Allewelt, J. Lorenz, P. Reimnitz, H. Lode, and The German Lung Abscess Study Group
AbstractBackground: Aspiration pneumonia (AP) and primary lung abscess (PLA), are diseases following aspiration of infectious material from the oropharynx or stomach. An antibiotic therapy, also covering anaerobic pathogens, is the treatment of choice. In this study we compared moxioxacin (MXF) and ampicillin/sulbactam (AMP/SUL) concerning efcacy and safety in the treatment of AP and PLA.
Methods: Patients with pulmonary infections following aspiration were included in a prospective, open-label, randomized, multicenter trial. Sequential antibiotic therapy with MXF or AMP/SUL was administered until complete radiologic and clinical resolution.
Results: A total of 139 patients with AP and PLA were included, 96 were evaluable for efcacy (EE, 48 patients in each treatment group). The overall clinical response rates in both groups were numerically identical (66.7%). MXF and AMP/SUL were both well tolerated, even after long-term administration [median duration of treatment (range) in days MXF versus AMP/SUL: AP 11 (445) vs 9 (325), PLA30.5 (7158) vs 35 (690)].
Conclusion: In the treatment of aspiration-associated pulmonary infections moxioxacin appears to be clinically as effective and as safe as ampicillin/sulbactam; but, however, having the additional benet of a more convenient (400 mg qd) treatment.
Infection 2008; 36: 2330 DOI 10.1007/s15010-007-7043-6
Introduction Aspiration pneumonia (AP) and primary lung abscess (PLA) are rare diseases, but they can result in life-threatening complications, including severe hemoptysis [1]. Mortality rates of up to 1520% have been reported in the literature [2, 3]. The initial step in the pathogenesis of these diseases is aspiration of infectious material from the oropharynx or stomach. Therefore the expected microbiological ora generally comprises a mixed spectrum, including anaerobic, microaerobic and aerobic microorganisms [46].
A number of risk factors for aspiration are known such as compromised consciousness, esophageal diseases, alcoholism, drug overdosage, seizure disorders, general anesthesia and neurological disorders [79]. Generally, AP and PLA present as subacute infections and the clinical signs are comparable to those of other forms of pneumonia. The primary therapeutic strategy for AP and PLA is an antibiotic treatment, which needs to be prolonged in the presence of abscess formation. Because of its good in-vitro activity against...