[A comparison of moxifloxacin and amoxicillin in the treatment of
community-acquired pneumonia in Latin America: results of a multicenter clinical
trial]. [Article in Spanish]
Author(s): Jardim JR, Rico G, de la Roza C, Obispo E, Urueta J, Wolff M, Miravitlles M;
Grupo de Estudio Latinoamericano CAP.
Affiliation(s): Universidade Federal de Sao Paulo. Sao Paulo. Brazil.
Publication date & source: 2003, Arch Bronconeumol. , 39(9):387-93
Since community-acquired pneumonia (CAP) is a common disease with a high
morbidity rate, it is important to obtain information concerning its etiology and
susceptibility to antibiotics across different geographic areas. This study
presents data obtained in 5 Latin American counties in the course of an
international clinical trial that evaluated the efficacy and safety of treatment
with either moxifloxacin or amoxicillin administered for 10 days to patients
suspected of having CAP caused by a pneumococcal infection. Details are given of
the pathogens identified, the patterns of sensitivity to antibiotics observed,
and the clinical and microbiological results obtained.A total of 84 patients were
studied, of whom 70 (83.3%) were evaluated at the end of the trial to determine
the efficacy and safety of the treatment received. Gram-positive bacteria were
found in samples from 29 patients (80.5%). The pathogen was Streptococcus
pneumoniae in 28 of those cases (77.7%). Gram-negative bacteria were found in 7
patients (19.4%), the most common being Haemophilus influenzae in 3 patients
(8.3%). The presence of atypical microorganisms was detected in 18 of the 70
patients (25%), mainly Mycobacterium pneumoniae (n=11), and in 6 cases (8.5%) the
infection was mixed. Ten strains of S. pneumoniae (35.7%) were shown to be
susceptible to penicillin, 2 (7.1%) were highly resistant, and 16 (57.1%) showed
moderate resistance. The clinical success rate at the final visit after treatment
was 94.1% for moxifloxacin and 91.7% for amoxicillin. The results of this trial
demonstrate a high prevalence of S. pneumoniae with reduced susceptibility to
penicillin in patients with CAP in Latin America. It also revealed a high
incidence of atypical pathogens and mixed infection in 8.6% of patients. This
information should be taken into account when establishing protocols for
empirical treatment of CAP in Latin America.
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