Moxifloxacin for Community-Acquired Pneumonia
Abstract
Moxifloxacin for Community-Acquired PneumoniaI read with great interest the moxifloxacin versus co-amoxiclav study in the June issue of Antimicrobial Agents and Chemotherapy (2).It is one of the very rare randomized controlled trials on the treatment of community-acquired pneumonia (CAP) that included a significant amount of severely ill patients and pretreated patients and that showed superiority in an intent-to-treat, as well as in an on-treatment, analysis.However, it remains unclear if the superiority of moxifloxacin is a consequence of better coverage of the so called "atypical agents," the increased effectiveness in patients with penicillin-resistant pneumococci, the choice of treatment in the control group, or any other reason.A further analysis of the data might therefore be instructive.It would be interesting to know if the difference in outcome between the two study groups is equally, not, or possibly more apparent in patients pretreated and those not pretreated with antibiotics?Is the difference in outcome between the two study groups clearer in those patients in whom any etiologic agent was demonstrated than in those in whom no agent was found?Very few CAP studies include a significant number of severely ill patients, and therefore, very little evidence from randomized controlled trials is available to guide the management of patients treated in intensive care units (ICUs).Possibly, the moxifloxacin study might give valuable information.Therefore, it would be…
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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.
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