Moxifloxacin monotherapy equivalent to antibiotic combo

(HealthDay)—Oral monotherapy with moxifloxacin is as efficacious and safe as combination therapy with ciprofloxacin plus amoxicillin/clavulanic acid for treatment of fever in adult patients with cancer and neutropenia who are at low risk of complications, according to a study published online Jan. 28 in the Journal of Clinical Oncology.

Winfried V. Kern, M.D., from the University Hospital in Freiburg, Germany, and colleagues conducted a double-blind multicenter study to compare the efficacy and safety of moxifloxacin monotherapy with oral combination therapy for febrile neutropenia in cancer patients with low risk of complications as defined by a Multinational Association for Supportive Care in Cancer score >20. Patients were assigned to receive either moxifloxacin monotherapy or oral ciprofloxacin plus amoxicillin/clavulanic acid.

The researchers found that, among the 333 patients included in the intention-to-treat analysis, therapy success was seen in 80 percent of the patients administered moxifloxacin and 82 percent of the patients administered combination therapy (95 percent confidence interval for the difference, −10 to 8 percent, consistent with equivalence). There were minor differences in tolerability, safety, and reasons for failure, but in the two groups, more than 50 percent of patients were discharged on protocol therapy, with 5 percent readmissions in each group. Survival was 99 percent in both groups.

"In conclusion, the data from this double-blind trial provide evidence that single-drug oral therapy in low-risk febrile neutropenia with moxifloxacin is equivalent to the combination therapy so far considered standard," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Bayer Healthcare, which funded the study.