Article
作者: Sasaki, Eisuke ; Izumikawa, Koichi ; Funada, Midori ; Imamura, Yoshifumi ; Morio, Ryosuke ; Irifune, Satoshi ; Futsuki, Yoji ; Fukuda, Yuichi ; Nemoto, Kazuki ; Kondo, Akira ; Iwanaga, Naoki ; Hata, Ryosuke ; Inoue, Yuichi ; Harada, Yosuke ; Yanagihara, Katsunori ; Ide, Shotaro ; Fukushima, Koki ; Takeda, Kazuaki ; Nagayoshi, Yosuke ; Shimabukuro, Ikuko ; Fukushima, Kiyoyasu ; Hanaka, Tetsuya ; Ito, Yuya ; Yoshida, Masataka ; Morikawa, Toru ; Tanaka, Hikaru ; Miyamura, Takuto ; Sawai, Toyomitsu ; Morimoto, Shimpei ; Hosogaya, Naoki ; Takazono, Takahiro ; Yatera, Kazuhiro ; Ota, Kenji ; Nakada, Nana ; Mukae, Hiroshi ; Suyama, Naofumi ; Mihara, Tomo
BACKGROUND:Nursing- and healthcare-associated pneumonia (NHCAP) constitutes most of the pneumonia in elderly patients including aspiration pneumonia in Japan. Lascufloxacin (LSFX) possesses broad antibacterial activity against respiratory pathogens, such as Streptococcus spp. And anaerobes inside the oral cavity. However, the efficacy and safety of LSFX in NHCAP treatment remains unknown. We aimed to evaluate the efficacy and safety of LSFX tablets in the treatment of patients with NHCAP.
METHODS:In this single-arm, open-label, uncontrolled study, LSFX was administered to patients with NHCAP at 24 facilities. The study participants were orally administered 75 mg LSFX once daily for 7 days. The primary endpoint was the clinical efficacy at the time of test of cure (TOC). The secondary endpoints included clinical efficacy at the time of end of treatment (EOT), early clinical efficacy, microbiological efficacy, and safety analysis.
RESULT:During the study period, 75 patients provided written informed consent to participate and were included. Finally, 56 and 71 patients were eligible for clinical efficacy and safety analyses, respectively. The median age of the patients was significantly high at 86 years. All patients were classified as having moderate disease severity using the A-DROP scoring system. LSFX tablets demonstrated high efficacy rates of 78.6 % at TOC and 89.3 % at EOT. The risk factors for resistant bacteria or aspiration pneumonia did not affect clinical efficacy. No severe adverse events associated with the study drugs were observed.
CONCLUSION:Oral LSFX is an acceptable treatment option for moderate NHCAP in elderly patients who can take oral medications.