Speed of recovery in adult patients with community-acquired pneumonia; moxifloxacin versus levofloxacin.

INTRODUCTION: To evaluate the speed of recovery in CAP-treated adults with Moxifloxacin versus levofloxacin. METHODOLOGY: A retrospective multicenter study between January 14, 2010 - March 23, 2017. Patients' records with the diagnosis of community-acquired pneumonia (CAP), age ≥ 18 and ≤ 60 years old, susceptible bacteria to the prescribed fluoroquinolone, completed three days of antimicrobial therapy and who were switched from parenteral to the oral form for the same antimicrobial agent were included. RESULTS: 701 charts were reviewed, 367 were excluded; not on respiratory fluoroquinolones (RFQ), age > 60 or < 18 years old, not enough data, prior antimicrobials, hospital-associated pneumonia, < 3 days of therapy, and one pregnant woman. 334 patients were Included; 167 levofloxacin and 167 moxifloxacin, with 68.5% males (P = 0.259), no significant difference in comorbidities (P > .05), but increased diabetes mellitus in moxifloxacin-treated patients (P = 0.012). No significant difference in Pneumonia Severity Index (PSI). Multivariate and univariate analysis demonstrated that day 3 rate of improvement; levofloxacin-treated patients 75.9% (95% CI, 69.9 to 81.8), and 84.0% (95% CI, 78.1 to 89.9) for Moxifloxacin (difference -8.1%, 95% CI, -16.5 - .003, P = 0.058). And day 5 rates of improvement in Levofloxacin-treated patients was 91.9%, (95% CI, 88.3 - 95.6), and 95.5% (95% CI, 91.8 - 99.2) for moxifloxacin (difference -3.5%, 95% CI, -8.7 - 1.7, P = 0.184). There was no significant difference for patients with radiological diagnoses for day 3 (P = 0.832) and 5 (P = 0.929). CONCLUSIONS: Our uni-and-multivariate analyses demonstrated that moxifloxacin exhibited no significant differences in the rates of improvement on days 3 and 5.

Major bleeding events in Jordanian patients undergoing percutaneous coronary intervention (PCI): Incidence, associated factors, impact on prognosis, and predictability of the CRUSADE bleeding risk score. Results from the First Jordanian PCR (PCR1).

OBJECTIVE: Determine the incidence of major bleeding events, their risk factors, and their impact on prognosis in Jordanian patients undergoing percutaneous coronary intervention (PCI). Evaluate the ability of the CRUSADE bleeding risk score (BRS) to predict major bleeding. METHODS: Major bleeding events were defined according to the CRUSADE classification and their incidence was evaluated from hospital admission to one year of follow up. The CRUSADE bleeding risk score was calculated for each patient during the index admission. Incidence of major bleeding events was evaluated in each of the bleeding score quintiles. JoPCR1 is a prospective, observational, multicenter registry of consecutive patients who underwent PCI at 12 tertiary care centers in Jordan. A case report form was used to record data prospectively at hospital admission, at discharge, and at 1 and 12 months of follow-up. RESULTS: The study included 2426 consecutive patients who underwent PCI. During the index hospitalization, major and minor bleeding events occurred in 0.95% and 2.6% of patients, respectively. Multivariate analysis showed that only two variables were significantly associated with major bleeding: female gender (OR=3.7; 95% CI 1.6, 8.5; p=0.002) and past history of cardiovascular disease (OR=2.6; 95% CI 1.1, 5.9; p=0.026). Patients who had in-hospital major bleeding events had higher cardiac mortality during index hospitalization (13.0% vs. 0.7%, p<0.005) and at one year of follow up (13.0% vs. 1.8%, p<0.005) compared to those who had no such events. Receiver operating characteristic curve analysis showed that the CRUSADE BRS has a high ability to predict major bleeding. CONCLUSION: Major bleeding events were uncommon in this ME registry of a contemporary cohort of patients undergoing PCI but were associated with a higher mortality rate compared with those who did not have major bleeding events. CRUSADE BRS was highly predictive of the incidence of major bleeding events.