4.6 Article

Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD

Journal

EUROPEAN RESPIRATORY JOURNAL
Volume 34, Issue 5, Pages 1066-1071

Publisher

EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.00195608

Keywords

Antibiotics; bacterial colonisation; chronic obstructive pulmonary disease; moxifloxacin

Funding

  1. Bayer Schering Pharma (Berlin, Germany)
  2. La Marato de TV3 (Barcelona, Spain)

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This study was designed to investigate the efficacy of moxifloxacin for the eradication of bacterial colonisation of the airways in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Out of 119 stable patients with COPD screened, 40 (mean age 69 yrs, mean forced expiratory volume in 1 s 50% predicted) were colonised with potentially pathogenic microorganisms (PPMs) and were included in a randomised, double-blind, placebo-controlled trial with moxifloxacin 400 mg daily for 5 days. Eradication rates were 75% with moxifloxacin and 30% with placebo at 2 weeks (p=0.01). Bacterial persistence at 8 weeks was still higher (not significantly) in the placebo arm (five (25%) out of 20 versus one (5%) out of 20; p=0.18). The frequencies of acquisition of a new PPM were high and similar in both treatment groups; consequently, the prevalence of colonisation at 8 weeks was also similar between treatment arms. No difference was found in the number of patients with exacerbations during the 5-month follow-up. Only the acquisition of a new PPM during follow-up showed a statistically significant relationship with occurrence of an exacerbation. Moxifloxacin was effective in eradicating PPMs in patients with positive sputum cultures. However, most patients were recolonised after 8 weeks of follow-up. Acquisition of a new strain of bacteria was associated with an increased risk of developing an exacerbation.

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