Moxifloxacina: profilo farmacologico, terapeutico e farmacoeconomico

Abstract

Moxifloxacin is a new fluorquinolone antibiotic, recently introduced among the treatment options for upper and lower airways infections. It possesses a wide antibiotic spectrum, covering the major pathogens involved in the genesis of community acquired pneumonia (CAP), acute exacerbations of chronic bronchitis (AECB) and acute bacterial sinusitis (ABS). It acts in a concentration-dependent manner by inhibition of bacterial DNAgirase and topoisomerase IV, has a long biological half-life (about 12 hours), good oral bioavailability, excellent tissue diffusion and a better safety profile than other quinolones, because of the lack of phototoxicity and the scarsity of clinically significant drug interactions. The clinical results of moxifloxacin in CAP, AECB and ABS have been compared with those of available alternative antibiotics in several multicentric, double-blind studies, and the new fluorquinolone resulted at least as effective as the comparators, with similar tolerability profiles. These studies demonstrated a high correlation among the eradication of the pathogen and the clinical recovery of the patients. The pharmacodynamics, pharmacokinetics and clinical results of moxifloxacin render it one of the most attractive options for the empirical treatment of upper and lower airways infections, more so since its pharmacoeconomic profile appears to be very convenient. In fact, the low dosing frequency (once daily), the possibility of oral administration, the quick onset of the therapeutic action, the high clinical and microbiological success rate even with low duration cycles (5 days) and the good safety profile make the cost/efficacy ratio of moxifloxacin in the treatment of common airways infections very advantageous in comparison to those of all available treatment alternatives.