Clinical efficacy and correlation of clinical outcomes with in vitro susceptibility for anaerobic bacteria in patients with complicated intra-abdominal infections treated with moxifloxacin
Abstract
BACKGROUND: Appropriate antimicrobial therapy results in improved clinical outcomes in complicated intra-abdominal infections (cIAIs). Recent in vitro studies have reported increasing moxifloxacin resistance of Bacteroides species, thereby cautioning empiric use in infections with these organisms.
METHODS: This pooled analysis of 4 randomized clinical trials (2000-2010) evaluated the comparative efficacy of moxifloxacin in cIAIs, including infection with anaerobic organisms. The intent-to-treat population included 1209 patients who received moxifloxacin (745 microbiologically valid cases) and 1193 patients who received comparator agents (741 microbiologically valid cases).
RESULTS: Overall clinical success rates in the per-protocol population were 85.6% (817 of 955 patients) for moxifloxacin and 87.8% (860 of 979 patients) for comparators. Of 642 pretherapy anaerobes from moxifloxacin-treated patients, 561 (87.4%) were susceptible at ≤2 mg/L, 34 (5.3%) were intermediate at 4 mg/L, and 47 (7.3%) were resistant at ≥8 mg/L. Moxifloxacin achieved similar clinical success rates against all anaerobes including those isolated from patients infected with Bacteroides fragilis (158 [82.7%] of 191 patients), Bacteroides thetaiotaomicron (74 [82.2%] of 90 patients) and Clostridium species (37 [80.4%] of 46 patients). The overall clinical success rate for all anaerobes was 82.3%. For all anaerobes combined, the clinical success rate was 83.1% (466 of 561 patients) for a minimum…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,209 participants or records.
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