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Newer Antibiotic more Effective at Treating
Pneumonia in Senior Citizens
Jan. 24, 2006 – Community-acquired pneumonia (CAP)
is the fifth-leading cause of death in America's senior citizens 65 and
older, but there appears to be new hope in this battle from a newer
antibiotic, moxifloxacin HCl, marketed as Avelox. In a new study it
proved more successful than the traditional antibiotic used for the last
decade.
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Treated with the newer medication, moxifloxacin HCI,
97.9 percent of hospitalized patients recovered within three to five
days of therapy onset, compared to 90 percent of patients treated with
the standard medication, levofloxacin, which is marketed as Levaquin.
The national study coordinated at The University of
Texas Health Science Center at San Antonio Study included 281 patients
at 47 centers.
CAP is diagnosed in 5.6 million adults annually in
the U.S., and is 60 percent more likely to occur in the elderly than in
the general population. Among those age 85 or older, at least 1 in 20
have to be hospitalized.
Research has shown that the appropriate and timely
administration of antibiotics to elderly CAP patients may lead to
decreased mortality and faster hospital discharge.
The Community-Acquired Pneumonia Recovery in the
Elderly (CAPRIE) study, led by Antonio Anzueto, M.D., professor of
medicine at the Health Science Center, is reported in the current issue
of Clinical Infectious Diseases.
"The CAPRIE study is very unique in that it was
conducted only in patients 65 and older, such as the median age was 78,"
Dr. Anzueto said. "Community-acquired pneumonia is a common infectious
disease process in the elderly. Pneumonia has been identified as the
leading infectious disease associated with the higher mortality (death)
in this age group. This is also the first time the two leading
antibiotics for CAP have been compared in a well-controlled clinical
trial."
"At the end of the day, another important question
was safety," Dr. Anzueto said. "This study involved very sophisticated
assessment of cardiac safety. We found both treatments to be safe." San
Antonio patients were treated at the South Texas Veterans Health Care
System.
Moxifloxacin HCI's greater efficacy earlier in
hospital stays should lead to less occurrence of incapacitating
long-term effects, Dr. Anzueto said.
There was no significant difference between the two
treatments with regard to cardiac safety, the primary endpoint of the
study, or clinical cure rates 5 to 21 days after the end of treatment,
the primary efficacy endpoint.
Additional analyses examined cure rates across CAP
severity and age subgroups, including mild to moderate CAP, severe CAP,
CAP in patients 65-74 years of age, and CAP in patients 75 years of age
or older. Patients treated with Avelox achieved a cure rate of 90
percent or greater in all CAP severity and age subgroups. The rates of
investigator-reported drug-related adverse events in the study were
similar for both treatment regimens.
Moxifloxacin HCI and levofloxacin are in a group of
antibiotics known as fluoroquinolones.
The cost of treating CAP patients is estimated at
$10 billion per year, with 92 percent of those costs spent on
hospitalized care.
The results of this clinical study are published in
the current issue of Clinical Infectious Diseases.
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