[Usefulness of moxifloxacin tablet on nursing and health care-associated pneumonia--a prospective study with a simple suspension method].

Abstract

Patients with nursing and health care-associated pneumonia (NHCAP) include those at risk for aspiration or those who have difficulties to take pills. We conducted a prospective study to examine the efficacy and safety of moxifloxacin (MFLX) administration through an enteral feeding tube by a simple suspension method in patients with NHCAP receiving long-term care at the hospital. The study was performed in subjects meeting the definition of NHCAP according to the Japanese Respiratory Society amongst patients with pneumonia who were fed by a feeding tube under long-term care at Makita General Hospital during the period from Dec. 2010 to Oct. 2011. A dose of 400 mg MFLX was administered once daily for three consecutive days, as a rule, through a gastrostomy or nasogastric feeding tube by a simple suspension method. The primary endpoint was a test of cure (TOC) 7 days after the last administration. Sixteen patients were included in the analysis of the study. As the patient background, 11 were assessed as long-term care level 5, 5 were not receiving care, and the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score was 4 in all patients. Twelve (75%) had experience of aspiration while 4 (25%) had none, and all had some underlying diseases (complications). The severity of pneumonia according to the A-DROP scoring system was mild in 1 patient (6%), moderate in 14 patients (88%) and severe in 1 patient (6%). A test of cure 7 days after the last administration, which was the primary endpoint, showed an efficacy rate of 81.3% (13/16 patients), while the efficacy evaluation 3 days after administration, which was an endpoint for early phase drug efficacy, showed that the drug was effective in all patients (100%; 16/16 patients). Neither adverse drug reactions nor abnormal laboratory findings were observed. MFLX administration through an enteral feeding tube by a simple suspension method was shown to be as highly effective as injection in patients with NHCAP having eating and swallowing disorders, indicating its potential to become an alternative option to conventional intravenous injection therapy.