Evidence map›Paper›PMID 22135277›Full record

Trial reportThe European respiratory journal2012

Moxifloxacin versus amoxicillin/clavulanic acid in outpatient acute exacerbations of COPD: MAESTRAL results.

Robert Wilson, Antonio Anzueto, Marc Miravitlles, Pierre Arvis, Jeff Alder, Daniel Haverstock, Mila Trajanovic, Sanjay Sethi

Erratum issuedOpen access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The European respiratory journal, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
4.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 74 citations in OpenAlex.

  1. Pooled it
  2. Antibiotics for exacerbations of chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2018
    Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Observational
  13. Article
  14. Review
  15. Article
  16. Article
  17. Review
  18. Acute exacerbations of COPD: risk factors for failure and relapse.International journal of chronic obstructive pulmonary disease · 2017
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 4 countries.

Robert WilsonHost Defence Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. r.wilson@rbht.nhs.uk
Antonio Anzueto
Marc Miravitlles
Pierre Arvis
Jeff Alder
Daniel Haverstock
Mila Trajanovic
Sanjay Sethi
Bayer (United States) · USBayer (Germany) · DEConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESRoyal Brompton Hospital · GBThe University of Texas Health Science Center at San Antonio · USUniversity at Buffalo, State University of New York · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bacterial infections causing acute exacerbations of chronic obstructive pulmonary disease (AECOPD) frequently require antibacterial treatment. More evidence is needed to guide antibiotic choice. The Moxifloxacin in Acute Exacerbations of Chronic Bronchitis TriaL (MAESTRAL) was a multiregional, randomised, double-blind non-inferiority outpatient study. Patients were aged ≥ 60 yrs, with an Anthonisen type I exacerbation, a forced expiratory volume in 1 s < 60% predicted and two or more exacerbations in the last year. Following stratification by steroid use patients received moxifloxacin 400 mg p.o. q.d. (5 days) or amoxicillin/clavulanic acid 875/125 mg p.o. b.i.d. (7 days). The primary end-point was clinical failure 8 weeks post-therapy in the per protocol population. Moxifloxacin was noninferior to amoxicillin/clavulanic acid at the primary end-point (111 (20.6%) out of 538, versus 114 (22.0%) out of 518, respectively; 95% CI -5.89-3.83%). In patients with confirmed bacterial AECOPD, moxifloxacin led to significantly lower clinical failure rates than amoxicillin/clavulanic acid (in the intent-to-treat with pathogens, 62 (19.0%) out of 327 versus 85 (25.4%) out of 335, respectively; p=0.016). Confirmed bacterial eradication at end of therapy was associated with higher clinical cure rates at 8 weeks post-therapy overall (p=0.0014) and for moxifloxacin (p=0.003). Patients treated with oral corticosteroids had more severe disease and higher failure rates. The MAESTRAL study showed that moxifloxacin was as effective as amoxicillin/clavulanic acid in the treatment of outpatients with AECOPD. Both therapies were well tolerated.

Indexed as

AgedAged, 80 and overAmbulatory CareAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsAza CompoundsBacterial InfectionsDouble-Blind MethodFemaleFluoroquinolonesHumansMaleMiddle AgedMoxifloxacinProspective StudiesPulmonary Disease, Chronic ObstructiveAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsAza CompoundsFluoroquinolonesMoxifloxacinQuinolines

Identifiers

PMID22135277
PMCPMC3393767
OpenAlexW2138817967

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.