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January 30, 2013 06:00

Infeksi bakterial yang terjadi pada pasien COPD eksaserbasi akut, terkadang memerlukan tindakan pengobatan dengan antibiotik. Studi terbaru menunjukkan bahwa moxifloxacin memberikan efek sebanding dengan kombinasi amoxicillin/clavulanic acid untuk pengobatan COPD eksaserbasi akut pada poli rawat jalan. Hal in merupakan kesimpulan dari studi yang dilakukan oleh Dr. R. Wilson, dari Host Defence Unit, Royal Brompton Hospital, Sydney Street, London yang dipublikasikan secara online dalam European Respiratory Journal Desember 2011.

MAESTRAL merupakan studi COPD multiregional, acak - tersamar ganda, non-inferioritas dengan melibatkan subyek rawat jalan, dengan eksaserbasi Anthonisen type 1, prediksi FEV1<60%, lebih dari 2x eksaserbasi pada setahun terakhir. Selanjutnya dilakukan stratifikasi berdasarkan penggunaan steroid dan mendapatkan moxifloxacin 400 mg PO q.d (5 hari) atau amoxicillin/clavulanic acid 875/125 mg PO b.d. (7 hari). Dan parameter utama daari studi ini adalah kegagalan klinis pada minggu ke-8 setelah terapi berdasarkan populasi per-protokol.

Dari studi tersebut moxifloxacin tidak inferior jika dibandingkan dengan amoxicillin/clavulanic acid, berdasarkan parameter utama penelitian (111/538, 20.6% vs 114/518, 22.0%, 95% CI –5.89, 3.83). Pada pasien dengan COPD eksaserbasi akut yang dikonfirmasi adanya bakteri, moxiflocin secara signifikan menurunkan tingkat kegagalan klinis daripada amoxicillin/clavulanic acid (ITT dengan patogen, 62/327, 85/335 vs 19,0%, 25,4%, P=0,016). Dikonfirmasi pemberantasan bakteri pada EOT dikaitkan dengan tingkat kesembuhan klinis lebih tinggi pada minggu ke-8 pasca-terapi keseluruhan (P=0,0014) dan untuk moxifloxacin (P=0,003). Pasien yang diobati dengan kortikosteroid oral memiliki penyakit yang lebih parah dan tingkat kegagalan yang lebih tinggi.

Berdasarkan studi tersebut menunjukkan bahwa moxifloxacin sebanding efektivitasnya dengan amoxicillin/clavulanic acid untuk pengobatan COPD eksaserbasi akut pada pasien rawat jalan, dan secara umum keduanya ditoleransi dengan baik.



Image: Ilustrasi



Posted in: Doctor News

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