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Efficacy of moxifloxacin in the treatment of bronchial colonisation in COPD.

Author(s): Miravitlles M, Marin A, Monso E, Vila S, de la Roza C, Hervas R, Esquinas C, Garcia M, Millares L, Morera J, Torres A

Affiliation(s): Fundacio Clinic, Institut D'Investigacions Biomediques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain. marcm@clinic.ub.es

Publication date & source: 2009-11, Eur Respir J., 34(5):1066-71. Epub 2009 Apr 22.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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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