A Multicenter, Randomized, Open, Comparative Study for the Efficacy and Safety of Oral Moxifloxacin 400 mg Once a Day and Clarithromycin 500 mg Twice Daily in Korean Patients with Acute Exacerbations of Chronic Bronchitis / 결핵

BACKGROUND: Moxifloxacin is a newly developed drug which is more potent and safe compared to previous fluoroquinolones. This drug effectively eradicates organisms such as beta-lactamase-producing or other resistant bacteria. Moxifloxacin is known to be effective in treating respiratory infections such as Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella spp. and Mycoplasma pneumoniae. METHODS: In a multicenter, randomized, open, comparative study, the efficacy and safety of oral moxifloxacin taken 400 mg once a day and clarithromycin taken 500 mg twice daily for 7 days were compared for the treatment of Korean patients with acute exacerbations of chronic bronchitis. RESULTS: A total of 170 patients were enrolled, and they were divided into two groups:87 in the moxifloxacin group and 83 in the clarithromycin group. Of those enrolled, 76 (35 for bacteriologic efficacy) in the moxifloxacin group and 77 (31 for bacteriologic efficacy) in the clarithromycin group were included in the efficacy analysis. All were included in the safety analysis. Clinical success was noted in 70 (92.1%) of 76 moxifloxacin-treated patients and 71 (92.2%) of 77 clarithromycin-treated patients. Bacteriologic success rate seemed to be higher in moxifloxacin group (73.5%) than in clarithromycin group (54.8%), but statistically insignificant (p=0.098). Drug susceptibility among organisms initially isolated was higher in moxifloxacin group on Streptococcus pneumoniae, Pseudomonas aeruginosa, Klebsiella pneumoniae(p<0.001). Adverse events were reported by 12.8% of 86 patients receiving moxifloxacin and 21.7% of 83 patients receiveing clarithromycin. Headache (4.7% vs 4.8%, moxiflosacin group vs clarithromycin group, respectively) and indigestion (2.3% vs 6.0%, moxifloxacin group vs clarithromycin group, respectively) were the most frequent side effects in the two groups. CONCLUSION: This study demonstrated that for the treatment of acute exacerbations of chronic bronchitis a 7-days course of moxifloxacin 400 mg od was clinically equivalent and microbiologically superior to clarithromycin 500 mg bid.

Measurement of Total Lung Capacity: A Comparison of Spiral CT and Spirometry

PURPOSE: To determine the potential of spiral CT as a functional imaging modality of the lung asid from its proven value in morphological depiction. MATERIALS AND METHODS: Spiral CT scan was performed in ten normal female and nine normal male adults (mean age: 39, height: 163cm, weight: 62kg) after single full breath-holding. Three dimensional lung images were reconstructed (minimal threshold value: -1,000HU, maximal threshold values: -150,-250, -350, -450HU) to obtain total lung volume(TLV) on a histogram. Total lung volume measured by spiral CT was compared with TLV obtained by spirometry. RESULTS: Mean TLV measured by spirometry was 5.62 Land TLV measured by CT at maximal threshold values of -150, -250, -350, and -450HU was 6.63, 5.33, 5.15, and 4.98 L, respectively. Mean absolute differences between the modalities of 0.17L(3%), 0.32L(5.6%), 0.48L(8.5%), 0.65L(11.5) were statistically significant(p<0.001). Linear regression coefficients between the modalities were 0.99, 0.97, 0.95,and 0.94 and no statistically significant differences in accuracy of threshold levels in the estimation of lung volume(r=0.99, standard error=0.034L in all) were seen. CONCLUSION: TLV measured by spiral CT closely approximated that measured by spirometry. Spiral CT may be useful as a means of evaluating lung function.