Moxifloxacin more favorable than amoxicillin/clavulanate for COPD exacerbations

Chronic obstructive pulmonary disease (COPD) affects a large number of subjects worldwide and is characterised by a progressively rising epidemiological, clinical and socio-economic impact. The objectives of treatment are to decrease the burden of the disease through relief of symptoms, improvement of exercise tolerance, and prevention and treatment of exacerbations.

Original research to investigate the long-term impact on health related quality of life (HRQL) of the antibiotic treatment of exacerbations of COPD in general practice, has been released in a new research paper, available from Dove Medical Press.

The investigation, comparing the effect of treatment of COPD exacerbations with moxifloxacin (400 mg/day for five days) and amoxicillin/clavulanate (500/125 mg three times a day for 10 days) on HRQL, is authored by Marc Miravitlles, Carles Llor, Jesús Molina, et al on behalf of the EVOCA Study Group, in Barcelona, Spain.

The EVOCA study was a prospective, observational, multi-centre study of a cohort of patients with COPD followed in primary care over a two-year period.

Eligible patients for the research were adults over 40 years of age, smokers or ex-smokers of at least 10 pack-years, with chronic bronchitis characterised by persistent cough and sputum production for three months per year for at least two consecutive years, and stable COPD.

A total of 27 family physicians participated in the study and recruited 236 patients with stable COPD. The study population of 229 patients, 218 men and 11 women, with a mean age of 68.2 years and stable COPD, participated in a prospective, observational study of two years’ duration.

The results show that COPD exacerbations (mean 2.7 episodes/patient) occurred in 136 patients (124 patients received the study medications [amoxicillin/clavulanate 54, moxifloxacin 70]). The differences between baseline and the final visit were higher for moxifloxacin compared with amoxicillin/clavulanate for total SGRQ score (-2.60 [13.1] vs 4.21 [16.2], P = 0.05) and “symptoms” subscale (-5.64 [16.7] vs 8.27 [21], P = 0.02). The same findings were observed in patients with two or more exacerbations.

The conclusions of the study indicate that in COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate.