%0 Journal Article %1 Goldstein2011 %A Goldstein, Ellie J C. %A Solomkin, Joseph S. %A Citron, Diane M. %A Alder, Jeffrey D. %D 2011 %J Clin Infect Dis %K quinolone drug drugresistance dosing %N 11 %P 1074--1080 %R 10.1093/cid/cir664 %T Clinical efficacy and correlation of clinical outcomes with in vitro susceptibility for anaerobic bacteria in patients with complicated intra-abdominal infections treated with moxifloxacin. %U http://dx.doi.org/10.1093/cid/cir664 %V 53 %X 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.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).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 inhibitory concentration (MIC) of ≤2 mg/L, 91.2\% (31 of 34 patients) for an MIC of 4 mg/L, 82.4\% (14 of 17 patients) for an MIC of 8 mg/L, 83.3\% (5 of 6 patients) for an MIC of 16 mg/L, and 66.7\% (16 of 24 patients) for an MIC of ≥32 mg/L.Moxifloxacin demonstrated clinical success for intra-abdominal infections caused by both aerobic and anaerobic isolates. More than 87\% of baseline anaerobic isolates from intra-abdominal infections were susceptible to moxifloxacin, and efficacy was maintained beyond the current susceptibility breakpoint MIC of ≤2 mg/L against major anaerobes.

@article{Goldstein2011, abstract = {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.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).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 inhibitory concentration (MIC) of ≤2 mg/L, 91.2\% (31 of 34 patients) for an MIC of 4 mg/L, 82.4\% (14 of 17 patients) for an MIC of 8 mg/L, 83.3\% (5 of 6 patients) for an MIC of 16 mg/L, and 66.7\% (16 of 24 patients) for an MIC of ≥32 mg/L.Moxifloxacin demonstrated clinical success for intra-abdominal infections caused by both aerobic and anaerobic isolates. More than 87\% of baseline anaerobic isolates from intra-abdominal infections were susceptible to moxifloxacin, and efficacy was maintained beyond the current susceptibility breakpoint MIC of ≤2 mg/L against major anaerobes.}, added-at = {2012-12-19T01:49:08.000+0100}, author = {Goldstein, Ellie J C. and Solomkin, Joseph S. and Citron, Diane M. and Alder, Jeffrey D.}, biburl = {https://www.bibsonomy.org/bibtex/2e5431633f2797dff55caa3b998eae62d/aorchid}, description = {see page 77 of notebook 00002}, doi = {10.1093/cid/cir664}, file = {:ID_General/CID.53.1074-moxiAbdinfxn.pdf:PDF}, groups = {public}, institution = {R. M. Alden Research Laboratory, Culver City, California, USA. ejcgmd@aol.com}, interhash = {be1ab6a1f6d12da477bda326663efa4e}, intrahash = {e5431633f2797dff55caa3b998eae62d}, journal = {Clin Infect Dis}, keywords = {quinolone drug drugresistance dosing}, language = {eng}, medline-pst = {ppublish}, month = Dec, number = 11, pages = {1074--1080}, pii = {cir664}, pmid = {21998288}, timestamp = {2012-12-19T01:49:08.000+0100}, title = {Clinical efficacy and correlation of clinical outcomes with in vitro susceptibility for anaerobic bacteria in patients with complicated intra-abdominal infections treated with moxifloxacin.}, url = {http://dx.doi.org/10.1093/cid/cir664}, username = {aorchid}, volume = 53, year = 2011 }