Rapid resolution of symptoms with moxifloxacin therapy in 7223 patients with acute exacerbation of chronic bronchitis - Comparison with prior macrolide treatment

Objectives: A post-marketing surveillance (PMS) study was conducted to evaluate the efficacy and tolerability of treatment with moxifloxacin 400mg once daily in patients with acute exacerbations of chronic bronchitis (AECB) treated in general practices in Germany. Of additional interest was the time until onset of action of moxifloxacin and the assessment of moxifloxacin by patients and physicians compared with a macrolide treatment of a prior AECB. Methods, design and patients: This multicentre-study was of an open-label, prospective, non-controlled. observational design. 7223 patients with AECB (52.9% male; 47.1% female) treated with moxifloxacin and with a history of macrolide antibiotic therapy for their last exacerbation were included in the analysis. Most patients (67.0%) received a 5-day course of moxifloxacin; 20.7% were treated for 6 to 7 days, Symptoms of AECB (cough, dyspnoea, expectoration, chest pain, fever, pathological auscultation) were assessed by the attending physician as 'absent', 'mild' or 'severe' at the initial and follow-up visit. Results: According to physicians' global assessments, 75.9% of patients (n = 5482) were cured and 22.3% (1610) were improved at the end of the observation period. 75% of patients experienced an improvement within 3 days after the start of moxifloxacin therapy and 94.9% of patients within 5 days. Recovery occurred in a mean of 6.2 days. Over 70% of physicians rated onset of improvement with moxifloxacin more rapid than with previous macrolide therapy. Moxifloxacin therapy was very well tolerated, with 97.8% of patients rating therapy as 'very good' or 'good'. The most commonly reported adverse events were dizziness and abdominal pain, with an overall incidence of adverse events of 0.7%. Conclusions: Moxifloxacin is a highly effective and well tolerated treatment for patients with AECB and is well accepted by both physicians and patients because of rapid symptom improvement following a short course of once-daily therapy.