amoxicillin-potassium-clavulanate-combination and sparfloxacin

A pooled data analysis of two double-blind studies encompassing 1137 episodes of community-acquired pneumonia in hospitalised adults, of which 560 were treated with sparfloxacin and 577 were randomised to comparator antibacterial agents (amoxycillin/clavulanic acid, erythromycin or amoxycillin administered at reference dosages), was performed. The global efficacy rate at the end of treatment in evaluable patients treated with sparfloxacin was 88.3% compared with 84.1% in those who received comparator antibacterial agents. This analysis verified the efficacy of this new aminofluoroquinolone, given orally once daily, in the treatment of community acquired pneumonia. The overall outcome favoured sparfloxacin for use in the empirical treatment of community-acquired pneumonia.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Clavulanic Acids; Community-Acquired Infections; Double-Blind Method; Drug Therapy, Combination; Erythromycin; Fluoroquinolones; Humans; Microbial Sensitivity Tests; Penicillins; Pneumonia, Bacterial; Quinolones; Streptococcus pneumoniae

In a double-blind, placebo-controlled trial, patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) were randomly allocated to oral treatment with sparfloxacin (200 mg loading dose followed by 100 mg once daily) or amoxycillin/clavulanic acid (500 mg/125 mg tds) for a total treatment duration of 7 to 14 days. Patients were evaluable if they had a FEV1/FVC ratio of less than 70% at stable state and presented with a suspected infectious exacerbation defined as increases in dyspnoea, sputum volume and sputum purulence. The primary efficacy variable was the overall success (defined as disappearance or improvement of dyspnoea and reductions in sputum volume and purulence) at end of treatment and follow-up. Overall efficacy was assessed in both the intent-to-treat (728 patients) and the evaluable (351 patients) populations. At the end of treatment and follow-up, success rates were identical for the sparfloxacin (87.3% and 78.7%) and amoxycillin-clavulanic acid (88.8% and 79.8%) treatment groups. Similar figures were found for the intent-to-treat population. The analysis of drug safety was similar for both treatment groups. The most frequently encountered pathogens were Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Sparfloxacin appeared superior for bacteriological eradication of Haemophilus influenzae, and Moraxella catarrhalis. Sparfloxacin in a single daily dose appears at least as effective as amoxycillin/clavulanic acid in the treatment of patients with acute exacerbations of COPD.

Topics: Acute Disease; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Infective Agents; Clavulanic Acids; Double-Blind Method; Drug Therapy, Combination; Fluoroquinolones; Haemophilus influenzae; Humans; Lung Diseases, Obstructive; Middle Aged; Moraxella catarrhalis; Quinolones; Streptococcus pneumoniae

We examined the cost-effectiveness of sparfloxacin compared with other selected oral antimicrobials in outpatient treatment of community-acquired pneumonia (CAP) using clinical pathway-based decision analysis. Cost estimates were obtained from medical claims databases and Medicare reimbursement schedules. Probability estimates were derived from published clinical trials, the medical literature, and clinical expert opinion. Overall adjusted efficacy rates were 89% for sparfloxacin, 79.4% for azithromycin, 77.8% for clarithromycin, 73% for cefaclor, 70.8% for amoxicillin-clavulanic acid, and 69% for erythromycin. The expected total cost/CAP episode of treatment with sparfloxacin was $216.07 compared with $258.97, $297.08, $345.75, $389.80, and $395.93 for azithromycin, clarithromycin, erythromycin, amoxicillin-clavulanic acid, and cefaclor, respectively. Therapy with sparfloxacin for managing CAP is cost effective-relative to other commonly prescribed antibiotics, resulting in net cost savings.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Antitubercular Agents; Azithromycin; Cefaclor; Clarithromycin; Community-Acquired Infections; Cost-Benefit Analysis; Erythromycin; Fluoroquinolones; Humans; Models, Economic; Outpatients; Pneumonia; Treatment Outcome

Seven laboratories, including a reference laboratory, tested the susceptibility of Moraxella catarrhalis, Streptococcus pneumoniae and Haemophilus influenzae strains to ciprofloxacin, clarithromycin, co-amoxiclav and sparfloxacin with the Etest. A total of 976 strains were collected. The results with ciprofloxacin and sparfloxacin were consistent for all laboratories, while those with clarithromycin and co-amoxiclav were not. The agreement between Etest MICs and broth microdilution was: ciprofloxacin and sparfloxacin, >95%; clarithromycin for all species, 71-85%; co-amoxiclav for H. influenzae, 31%. MIC90 values (broth dilution, mg/L) for M. catarrhalis, S. pneumoniae and H. influenzae were: sparfloxacin, 0.06, 0.5, 0.03; ciprofloxacin, 0.12, 2.0, 0.03; co-amoxiclav, 0.25, 0.25, 0.25; clarithromycin 0.25, 0.25 and 16.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Ciprofloxacin; Clarithromycin; Clavulanic Acids; Drug Evaluation; Drug Therapy, Combination; Fluoroquinolones; Haemophilus influenzae; Microbial Sensitivity Tests; Moraxella catarrhalis; Quinolones; Streptococcus pneumoniae