5. Clinical efficacy of gemifloxacin
The rise in multidrug-resistant (MDR) S. pneumoniae and -lactam-resistant H. influenzae and M. catarrhalis has
highlighted the role of fluoroquinolones in recent disease guidelines [1,22]. Agents such as gemifloxacin and other
respiratory fluoroquinolones such as moxifloxacin play an important role in the management of the defined ‘at-risk’
patients identified by stratification criteria.
5.1. Gemifloxacin in community-acquired pneumonia
(CAP)
The clinical data for gemifloxacin given orally once daily at 320 mg were derived from a number of randomised comparative trials designed to show non-inferiority; in addition, gemifloxacin was found to be superior for some important endpoints. Ball et al. evaluated gemifloxacin in CAP and found that clinical success at follow-up (21–28 days, intentto-treat (ITT)) was 82.9% and bacteriological success in the ITT population was 77.9% [23].Gemifloxacin was compared with intravenous (i.v.) ceftriaxone/oral cefuroxime (2 g i.v. ceftriaxone once daily for 1–7 days followed by oral cefuroxime 500 mg for 1–13 days) with or without a macrolide for the treatment of patients hospitalised with CAP [24]. At follow-up, clinical success was 92.2% for gemifloxacin-treated patients versus 93.4% in the ceftriaxone/cefuroxime ± a macrolide group. Clinical efficacy was 87% versus 83.3%, respectively,
for patients in Fine classes IV and V, and the addition of a macrolide did not affect clinical response at follow-up.
Overall there were 26 bacteraemic patients and all were clinical successes at the end of therapy. Bacteriological success
5. Clinical efficacy of gemifloxacinThe rise in multidrug-resistant (MDR) S. pneumoniae and -lactam-resistant H. influenzae and M. catarrhalis hashighlighted the role of fluoroquinolones in recent disease guidelines [1,22]. Agents such as gemifloxacin and otherrespiratory fluoroquinolones such as moxifloxacin play an important role in the management of the defined ‘at-risk’patients identified by stratification criteria.5.1. Gemifloxacin in community-acquired pneumonia(CAP) The clinical data for gemifloxacin given orally once daily at 320 mg were derived from a number of randomised comparative trials designed to show non-inferiority; in addition, gemifloxacin was found to be superior for some important endpoints. Ball et al. evaluated gemifloxacin in CAP and found that clinical success at follow-up (21–28 days, intentto-treat (ITT)) was 82.9% and bacteriological success in the ITT population was 77.9% [23].Gemifloxacin was compared with intravenous (i.v.) ceftriaxone/oral cefuroxime (2 g i.v. ceftriaxone once daily for 1–7 days followed by oral cefuroxime 500 mg for 1–13 days) with or without a macrolide for the treatment of patients hospitalised with CAP [24]. At follow-up, clinical success was 92.2% for gemifloxacin-treated patients versus 93.4% in the ceftriaxone/cefuroxime ± a macrolide group. Clinical efficacy was 87% versus 83.3%, respectively,for patients in Fine classes IV and V, and the addition of a macrolide did not affect clinical response at follow-up.Overall there were 26 bacteraemic patients and all were clinical successes at the end of therapy. Bacteriological success
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