Original Articles
Clinical Efficacy of Moxifloxacin in the Treatment of Exacerbations of Chronic Bronchitis: A Systematic Review and Meta-Analysis
Marc Miravitllesa,
, Jesús Molinab, Max Brosac
Corresponding author
marcm@clinic.ub.es
Correspondence: Dr. M. Miravitlles. Servei de Pneumologia. Institut Clínic del Tòrax. Hospital Clínic. Villarroel, 170 (UVIR, esc. 2, planta 3). 08036 Barcelona. España
Correspondence: Dr. M. Miravitlles. Servei de Pneumologia. Institut Clínic del Tòrax. Hospital Clínic. Villarroel, 170 (UVIR, esc. 2, planta 3). 08036 Barcelona. España
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"Marc Miravitlles, Jesús Molina, Max Brosa" "autores" => array:3 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "Marc" "apellidos" => "Miravitlles" "email" => array:1 [ 0 => "marcm@clinic.ub.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Jesús" "apellidos" => "Molina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Max" "apellidos" => "Brosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servei de Pneumologia, Institut Clínic del Tòrax (IDIBAPS), Hospital Clínic, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Centro de Salud Francia, Fuenlabrada, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Oblikue Consulting, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. M. Miravitlles. Servei de Pneumologia. Institut Clínic del Tòrax. Hospital Clínic. Villarroel, 170 (UVIR, esc. 2, planta 3). 08036 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-10-25" "fechaAceptado" => "2006-05-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154576" "palabras" => array:5 [ 0 => "Moxifloxacin" 1 => "Exacerbations" 2 => "Chronic bronchitis" 3 => "Antibiotics" 4 => "Meta-analysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154577" "palabras" => array:5 [ 0 => "Moxifloxacino" 1 => "Agudizaciones" 2 => "Bronquitis crónica" 3 => "Antibióticos" 4 => "Metaanálisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">As the research undertaken to date on the efficacy of the new antibiotics in the treatment of exacerbations of chronic bronchitis has taken the form of trials designed to demonstrate equivalence, we have no data on the advantages associated with the use of these new drugs with greater bactericidal activity. Our objective was to compare the clinical efficacy of moxifloxacin to that of the antibiotic regimens routinely used to treat such exacerbations by a systematic review of the literature and a meta-analysis.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">A manual and electronic search was performed to identify all clinical trials carried out between January 1997 and July 2005 to compare moxifloxacin and the antibiotics that are currently the first line treatment for exacerbations of chronic bronchitis. Once it had been established that the designs of the trials included were acceptable, a meta-analysis of clinical outcomes was performed.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 45 studies identified, 9 met the inclusion criteria. Of these, 5 were double-blind randomized trials and 4 were randomized open trials. The 9 trials comprised a total of 3905 patients. The aggregate standardized mean difference in clinical success rate was 1.5% (95% confidence interval, -04% to 3.4%). Bacterial eradication rates ranged from 68.4% to 96% for the standard regimens, and from 87.7% to 96% for moxifloxacin. No intergroup differences in the percentages of patients lost to follow-up were observed in any of the studies.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Although the trials reviewed were designed to demonstrate equivalence, meta-analysis revealed that the clinical success rate achieved with moxifloxacin tended to be higher than that obtained in the groups that received standard antibiotic treatment.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Debido a que los ensayos clínicos de eficacia de los nuevos antibióticos en las agudizaciones de la bronquitis crónica se han diseñado para demostrar equivalencia, no co-nocemos las ventajas que pueden aportar los nuevos fárma-cos con mayor actividad bactericida. Mediante un análisis sistemático y un metaanálisis de ensayos publicados se pretende comparar la eficacia clínica del moxifloxacino con la de otros antibióticos utilizados habitualmente en esta indicación.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado una búsqueda electrónica y manual de ensayos clínicos que comparen el moxifloxacino con antibióticos de referencia para las agudizaciones de la bronquitis crónica desde enero de 1997 hasta julio de 2005. Después de verificar su adecuado diseño, se ha elaborado un metaanálisis de sus resultados clínicos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se identificaron 45 trabajos, de los que 9 cumplían los criterios de inclusión. Cinco eran aleatorizados y doble ciego, y 4 aleatorizados y abiertos. En total, reunie-ron a 3.905 pacientes. Globalmente, la diferencia media es-tandarizada en tasa de éxito clínico fue del 1,5% (intervalo de confianza del 95%, del -0,4 al 3,4%). La tasa de erradicación bacteriológica con comparadores osciló entre el 68,4 y el 96%, y con moxifloxacino entre el 87,7 y el 96%. No se observaron diferencias en las tasas de pérdidas entre los grupos de tratamiento en ningún estudio.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">A pesar de tratarse de ensayos destinados a demostrar equivalencia, el metaanálisis realizado muestra una tendencia a la superioridad en la tasa de éxito clínico con moxifloxacino respecto a los comparadores.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was financed by Laboratorios Esteve S.A.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El fracaso en el tratamiento de las agudizaciones de la enfermedad pulmonar obstructiva crónica. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 3 | 7 |
| 2024 October | 30 | 14 | 44 |
| 2024 September | 25 | 26 | 51 |
| 2024 August | 46 | 43 | 89 |
| 2024 July | 26 | 17 | 43 |
| 2024 June | 36 | 37 | 73 |
| 2024 May | 49 | 50 | 99 |
| 2024 April | 21 | 32 | 53 |
| 2024 March | 23 | 16 | 39 |
| 2024 February | 16 | 27 | 43 |
| 2023 March | 5 | 1 | 6 |
| 2023 February | 27 | 17 | 44 |
| 2023 January | 38 | 25 | 63 |
| 2022 December | 33 | 34 | 67 |
| 2022 November | 50 | 32 | 82 |
| 2022 October | 48 | 35 | 83 |
| 2022 September | 80 | 36 | 116 |
| 2022 August | 32 | 39 | 71 |
| 2022 July | 56 | 43 | 99 |
| 2022 June | 20 | 32 | 52 |
| 2022 May | 42 | 31 | 73 |
| 2022 April | 59 | 39 | 98 |
| 2022 March | 28 | 41 | 69 |
| 2022 February | 56 | 29 | 85 |
| 2022 January | 42 | 29 | 71 |
| 2021 December | 54 | 49 | 103 |
| 2021 November | 42 | 52 | 94 |
| 2021 October | 37 | 47 | 84 |
| 2021 September | 31 | 63 | 94 |
| 2021 August | 40 | 30 | 70 |
| 2021 July | 21 | 32 | 53 |
| 2021 June | 34 | 29 | 63 |
| 2021 May | 12 | 30 | 42 |
| 2021 April | 57 | 91 | 148 |
| 2021 March | 17 | 16 | 33 |
| 2021 February | 25 | 23 | 48 |
| 2021 January | 16 | 14 | 30 |
| 2020 December | 25 | 10 | 35 |
| 2020 November | 14 | 17 | 31 |
| 2020 October | 16 | 8 | 24 |
| 2020 September | 12 | 6 | 18 |
| 2020 August | 34 | 11 | 45 |
| 2020 July | 38 | 9 | 47 |
| 2020 June | 13 | 13 | 26 |
| 2020 May | 32 | 9 | 41 |
| 2020 April | 12 | 29 | 41 |
| 2020 March | 9 | 16 | 25 |
| 2020 February | 16 | 20 | 36 |
| 2020 January | 22 | 18 | 40 |
| 2019 December | 22 | 15 | 37 |
| 2019 November | 13 | 12 | 25 |
| 2019 October | 4 | 21 | 25 |
| 2019 September | 15 | 20 | 35 |
| 2019 August | 12 | 11 | 23 |
| 2019 July | 12 | 17 | 29 |
| 2019 June | 12 | 8 | 20 |
| 2019 May | 10 | 10 | 20 |
| 2019 April | 15 | 22 | 37 |
| 2019 March | 13 | 14 | 27 |
| 2019 February | 14 | 13 | 27 |
| 2019 January | 12 | 13 | 25 |
| 2018 December | 8 | 11 | 19 |
| 2018 November | 25 | 11 | 36 |
| 2018 October | 27 | 20 | 47 |
| 2018 September | 8 | 13 | 21 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 8 | 4 | 12 |
| 2018 March | 5 | 3 | 8 |
| 2018 February | 9 | 14 | 23 |
| 2018 January | 4 | 2 | 6 |
| 2017 December | 7 | 5 | 12 |
| 2017 November | 2 | 3 | 5 |
| 2017 October | 4 | 8 | 12 |
| 2017 September | 5 | 13 | 18 |
| 2017 August | 7 | 12 | 19 |
| 2017 July | 1 | 7 | 8 |
| 2017 June | 7 | 13 | 20 |
| 2017 May | 5 | 22 | 27 |
| 2017 April | 2 | 9 | 11 |
| 2017 March | 3 | 20 | 23 |
| 2017 February | 1 | 6 | 7 |
| 2017 January | 2 | 10 | 12 |
| 2016 December | 8 | 9 | 17 |
| 2016 November | 10 | 12 | 22 |
| 2016 October | 7 | 19 | 26 |
| 2016 September | 13 | 18 | 31 |
| 2016 August | 7 | 4 | 11 |
| 2016 July | 3 | 3 | 6 |
| 2016 April | 1 | 0 | 1 |
| 2016 March | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 45 | 8 | 53 |
| 2015 September | 64 | 10 | 74 |
| 2015 August | 37 | 10 | 47 |
| 2015 July | 36 | 3 | 39 |
| 2015 June | 40 | 8 | 48 |
| 2015 May | 60 | 11 | 71 |
| 2015 April | 31 | 8 | 39 |
| 2015 March | 43 | 1 | 44 |
| 2015 February | 27 | 6 | 33 |
| 2015 January | 33 | 7 | 40 |
| 2014 December | 34 | 6 | 40 |
| 2014 November | 35 | 5 | 40 |
| 2014 October | 44 | 6 | 50 |
| 2014 September | 36 | 6 | 42 |
| 2014 August | 52 | 11 | 63 |
| 2014 July | 57 | 10 | 67 |
| 2014 June | 70 | 5 | 75 |
| 2014 May | 62 | 11 | 73 |
| 2014 April | 50 | 5 | 55 |
| 2014 March | 48 | 9 | 57 |
| 2014 February | 48 | 8 | 56 |
| 2014 January | 36 | 11 | 47 |
| 2013 December | 46 | 9 | 55 |
| 2013 November | 29 | 5 | 34 |
| 2013 October | 38 | 8 | 46 |
| 2013 September | 35 | 8 | 43 |
| 2013 August | 44 | 8 | 52 |
| 2013 July | 55 | 16 | 71 |
| 2013 June | 35 | 9 | 44 |
| 2013 May | 32 | 6 | 38 |
| 2013 April | 25 | 2 | 27 |
| 2013 March | 9 | 2 | 11 |
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