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This Article Full Text Full Text (PDF) All Versions of this Article: 34/5/1066    most recent 09031936.00195608v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Miravitlles, M. Articles by Torres, A. PubMed PubMed Citation Articles by Miravitlles, M. Articles by Torres, A.

Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD

¹ Fundació Clínic, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), ² Dept of Pneumology, Hospital Germans Trias i Pujol, Autonomous University of Barcelona, ³ Dept of Pneumology, Hospital Germans Trias i Pujol, Ciber de Enfermedades Respiratorias (CIBERES), ⁴ Medical Dept, Bayer Schering Pharma, and ⁵ Dept of Pneumology, Institut Clínic del Tòrax (IDIBAPS), Hospital Clínic, Ciber de Enfermedades Respiratorias (CIBERES), Universitat de Barcelona, Barcelona, Spain.

CORRESPONDENCE: M. Miravitlles, Servei de Pneumologia, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain. E-mail: marcm{at}clinic.ub.es

Keywords: Antibiotics, bacterial colonisation, chronic obstructive pulmonary disease, moxifloxacin

Received: December 24, 2008
Accepted April 2, 2009

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.