Objective To compare the systematic and lung pharmacokinetic parameters of moxifloxacin hydrochloride and explore a feasible tool to monitor drug concentration and evaluate therapeutic efficacy of respiratory fluoroquinolones. Methods Ten adult patients with community-acquired pneumonia or acute exacerbation of chronic bronchitis were enrolled.The subjects received a single dose of oral moxifloxacin hydrochloride 400 mg. Serum specimens were sampled at 0，1，2，3，4，8，24 h and sputum specimens were collected 0，1，2，4，8，20，24 h after administration，respectively.The serum and sputum concentrations of moxifloxacin hydrochloride were assayed by means of high-performance liquid chromatography. Standard pharmacokinetic parameters including peak concentrations(Cmax) and area under the concentration-time curve (AUC0-24 h) were assessed. Results Serum C(max) was（5.95±1.35）mg/L at 2 hours and serum AUC0-24 h was (58.72±8.11）mg·h-1·L-1 while sputum Cmax and AUC0-24 h were （16.18±6.47）mg/L at 3 hours and （138.04±78.29）mg·h-1·L-1 respectively，which were significantly higher than those in serum. Conclusion Oral administration of moxifloxacin hydrochloride to patients with respiratory infections results in rapid penetration into lung and maintain a one-fold drug concentration compared to blood concentration within 24 hours.Sputum drug concentration analysis demonstrates a superior pharmacokinetic profile of moxifloxacin in respiratory tract.
Objective To assess the effectiveness and safety of moxifloxacin versus levofloxacin for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were electronically searched, and the relevant conference proceedings were also hand-searched. The search time was up to July, 2011. Randomized controlled trials (RCTs) on moxifloxacin versus levofloxacin for AECOPD were included. Literature was screened according to inclusive and exclusive criteria, data were extracted, quality was assessed, and then meta-analysis was performed using RevMan 5.0. Results A total of 6 RCTs involving 482 patients with AECOPD were included. The results of meta-analysis showed that moxifloxacin group was significantly superior to levofloxacin group in the effective rate (OR=3.15, 95%CI 1.80 to 5.49, Plt;0.000 1). The bacterial clearance rate in moxifloxacin group was also higher than that in the levofloxacin group (OR=2.79, 95%CI 1.30 to 5.97, P=0.008). In addition, adverse effects of moxifloxacin group were less than levofloxacin (OR=0.48, 95%CI 0.24 to 0.98, P=0.04). Conclusion Based on current studies, moxifloxacin is superior to levofloxacin in improving effective rate and bacterial clearance rate, and in lowering side effects when treating AECOPD. Hence it is considerable to use moxifloxacin instead of levofloxacin in the treatment of AECOPD if necessary. Due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed with more high quality and large sample studies.
ObjectiveTo systemically review the efficacy and safety of moxifloxacin for mycoplasma pneumoniae. MethodsSuch databases as PubMed, The Cochrane library (Issue 4, 2014), ISI, CBM, CNKI, VIP and WanFang Data were searched from inception to April 2014 for randomized controlled trials (RCTs) concerning moxifloxacin for mycoplasma pneumoniae. Two reviewers screened literature according to the inclusion and exclusion criteria, extract data, and assess methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 401 patients were included. The results of meta-analysis showed that:compared with erythrocin or azithromycin, moxifloxacin had higher recovery rate (OR=2.35, 95%CI 1.76 to 3.15, P<0.000 01), higher bacterium negative rate (OR=3.74, 95%CI 1.76 to 7.96, P=0.000 6), and shorter fever clearance time (MD=-1.07, 95%CI -1.43 to -0.71, P<0.000 01); compared with azithromycin alone, moxifloxacin combined with azithromycin had higher recovery rate (OR=1.63, 95%CI 1.09 to 2.42, P=0.02), higher bacterium negative rate (OR=5.78, 95%CI 2.41 to 13.84, P<0.000 1), and shorter fever clearance time (MD=-0.99, 95%CI -1.52 to -0.47, P=0.000 2). In addition, there was a lower incidence of liver damage (OR=0.16, 95%CI 0.04 to 0.72, P=0.02) in patients who took moxifloxacin compared with erythromycin or azithromycin. No significant difference was found in the incidence of gastrointestinal adverse reaction between the two groups. ConclusionMoxifloxacin for mycoplasma pneumonia is more effective than macrolides (erythrocin or azithromycin) with a lower incidence of adverse reaction. Due to limited quantity and quality of the included studies, the above conclusion should be further verified by conducting more high quality, large scale, multicentre RCTs.