Role of moxifloxacin for the treatment of commmunity-acquired complicated intra-abdominal infections in Taiwan

Yeu Jun Lau, Yen Hsu Chen, Ching Tai Huang, Wen Sen Lee, Cheng Yi Liu, Jien Wei Liu, Hsiao Dong Liu, Yuarn Jang Lee, Chao Wen Chen, Wen Chien Ko, Po Ren Hsueh

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Complicated intra-abdominal infections (cIAIs) are common yet serious infections that can potentially lead to substantial morbidity and morbidity. As an essential adjunct to source control, the goals of antimicrobial therapy are to promote patient recovery, reduce recurrence risk, and prevent antimicrobial resistance. The current international guidelines on the empirical treatment of community-acquired complicated IAIs were published by the Infectious Diseases Society of America (IDSA) and Surgical Infections Society (SIS) in 2010. These guidelines all recommend the use of a fluoroquinolone (ciprofloxacin or levofloxacin) plus metronidazole for mild-to-moderate- and high-severity cases. Moxifloxacin monotherapy is recommended by the current IDSA/SIS guidelines for the treatment of mild-to-moderate complicated IAIs. Moxifloxacin has demonstrated a broad spectrum coverage of both aerobic and anaerobic pathogens, good tissue penetration into the gastrointestinal tract, and a good tolerability profile. Clinical data have demonstrated that moxifloxacin is at least as effective as other standard therapeutic regimens recommended by current clinical guidelines. Due to the high rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and fluoroquinolone-resistant Enterobacteriaceae among isolates causing community-acquired IAIs in Asia, any fluoroquinolones (including moxifloxacin) are not recommended as drugs of choice for the empirical treatment of community-acquired IAIs, particularly in countries (China, India, Thailand, and Vietnam) with fluoroquinolone resistance rates among Escherichia coli isolates of >20%. Given the low rates of fluoroquinolone-resistant (<20%) and extended-spectrum β-lactamase (ESBL)-producing (<10%) Enterobacteriaceae isolates associated community-acquired IAIs in Taiwan, it appears that moxifloxacin is considered an appropriate first-line therapy for patients with community-acquired complicated IAIs in this country.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume45
Issue number1
DOIs
Publication statusPublished - 2012 Feb 1

Fingerprint

Intraabdominal Infections
Taiwan
Fluoroquinolones
Enterobacteriaceae
Guidelines
Therapeutics
Infection
Morbidity
Levofloxacin
Vietnam
Metronidazole
Thailand
Ciprofloxacin
Communicable Diseases
Gastrointestinal Tract
moxifloxacin
India
China
Escherichia coli
Recurrence

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Lau, Yeu Jun ; Chen, Yen Hsu ; Huang, Ching Tai ; Lee, Wen Sen ; Liu, Cheng Yi ; Liu, Jien Wei ; Liu, Hsiao Dong ; Lee, Yuarn Jang ; Chen, Chao Wen ; Ko, Wen Chien ; Hsueh, Po Ren. / Role of moxifloxacin for the treatment of commmunity-acquired complicated intra-abdominal infections in Taiwan. In: Journal of Microbiology, Immunology and Infection. 2012 ; Vol. 45, No. 1. pp. 1-6.
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abstract = "Complicated intra-abdominal infections (cIAIs) are common yet serious infections that can potentially lead to substantial morbidity and morbidity. As an essential adjunct to source control, the goals of antimicrobial therapy are to promote patient recovery, reduce recurrence risk, and prevent antimicrobial resistance. The current international guidelines on the empirical treatment of community-acquired complicated IAIs were published by the Infectious Diseases Society of America (IDSA) and Surgical Infections Society (SIS) in 2010. These guidelines all recommend the use of a fluoroquinolone (ciprofloxacin or levofloxacin) plus metronidazole for mild-to-moderate- and high-severity cases. Moxifloxacin monotherapy is recommended by the current IDSA/SIS guidelines for the treatment of mild-to-moderate complicated IAIs. Moxifloxacin has demonstrated a broad spectrum coverage of both aerobic and anaerobic pathogens, good tissue penetration into the gastrointestinal tract, and a good tolerability profile. Clinical data have demonstrated that moxifloxacin is at least as effective as other standard therapeutic regimens recommended by current clinical guidelines. Due to the high rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and fluoroquinolone-resistant Enterobacteriaceae among isolates causing community-acquired IAIs in Asia, any fluoroquinolones (including moxifloxacin) are not recommended as drugs of choice for the empirical treatment of community-acquired IAIs, particularly in countries (China, India, Thailand, and Vietnam) with fluoroquinolone resistance rates among Escherichia coli isolates of >20{\%}. Given the low rates of fluoroquinolone-resistant (<20{\%}) and extended-spectrum β-lactamase (ESBL)-producing (<10{\%}) Enterobacteriaceae isolates associated community-acquired IAIs in Taiwan, it appears that moxifloxacin is considered an appropriate first-line therapy for patients with community-acquired complicated IAIs in this country.",
author = "Lau, {Yeu Jun} and Chen, {Yen Hsu} and Huang, {Ching Tai} and Lee, {Wen Sen} and Liu, {Cheng Yi} and Liu, {Jien Wei} and Liu, {Hsiao Dong} and Lee, {Yuarn Jang} and Chen, {Chao Wen} and Ko, {Wen Chien} and Hsueh, {Po Ren}",
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Role of moxifloxacin for the treatment of commmunity-acquired complicated intra-abdominal infections in Taiwan. / Lau, Yeu Jun; Chen, Yen Hsu; Huang, Ching Tai; Lee, Wen Sen; Liu, Cheng Yi; Liu, Jien Wei; Liu, Hsiao Dong; Lee, Yuarn Jang; Chen, Chao Wen; Ko, Wen Chien; Hsueh, Po Ren.

In: Journal of Microbiology, Immunology and Infection, Vol. 45, No. 1, 01.02.2012, p. 1-6.

Research output: Contribution to journalReview article

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AU - Lau, Yeu Jun

AU - Chen, Yen Hsu

AU - Huang, Ching Tai

AU - Lee, Wen Sen

AU - Liu, Cheng Yi

AU - Liu, Jien Wei

AU - Liu, Hsiao Dong

AU - Lee, Yuarn Jang

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AU - Ko, Wen Chien

AU - Hsueh, Po Ren

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