Respiratory fluoroquinolones are important agents in the management of patients with community-acquired pneumonia (CAP). Gemifloxacin is a new potent fluoroquinolone with excellent activity against CAP pathogens.
Pooled data from 5 phase III CAP gemifloxacin clinical trials were evaluated. Patients were grouped based on risk factors indicated in the IDSA guidelines [Mandell et al.2003 CID 37:1405]. Clinical response (success or failure) at end of therapy (EOT) & at follow-up (FU, approx. 1-3 weeks after treatment) was studied. Main comparators for CAP patients were cefuroxime & clarithromycin (322 patients), trovafloxacin (282 patients) & amoxicillin-clavulanate (156 patients).
Percent success is shown in table (AB, antibiotics, COPD, chronic bronchitis and obstructive lung disease, HD, heart disease, *includes patients that did not score a response at FU and were counted as clinical failure).
These data support the use of gemifloxacin in the treatment of CAP, especially where the patient has recognised IDSA risk factors.
Although gemifloxacin showed lower % success than comparator against CAP patients with no defined risk factor, gemifloxacin was considerably more successful than comparator against patients associated with risk factors. This advantage was even more prominent at FU than at EOT. Patients with other comorbidities such as renal failure or malignancy were not recruited in sufficient number for analysis.
Risk FactorTreatment% Success (number of patients)EOTFUCAP AllGemifloxacin86.9% (1166)80.9% (1164)Comparator87.2% (933)81.6% (928)Prior ABGemifloxacin86.9% (291)82.1% (291)Comparator86.6% (262)79.0% (262)DiabetesGemifloxacin87.6% (129)82.2% (129)Comparator86.6% (82)77.8% (81)COPDGemifloxacin85.6% (181)77.3% (181)Comparator83.7% (190)73.7% (190)*HDGemifloxacin88.8% (356)82.9% (356)Comparator86.0% (299)79.9% (298)
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