For Community-Acquired Pneumonia, Oral Lefamulin Noninferior to Moxifloxacin

By Kelly Young

Edited by André Sofair, MD, MPH

Oral lefamulin, a pleuromutilin antibiotic recently approved by the FDA, is noninferior to oral moxifloxacin for community-acquired pneumonia, according to an industry-conducted phase III trial in JAMA.

Over 700 adults with community-acquired pneumonia were randomized to either 5 days of lefamulin or 7 days of moxifloxacin.

Clinical response at 96 hours after starting treatment was 91% in both groups. But the lefamulin group had a higher rate of treatment-emergent adverse events (33% vs. 25%), particularly mild-to-moderate gastrointestinal events.

An editor's note says that the cost of lefamulin (over $200 a day) and adverse events (e.g., diarrhea) are likely to be concerns. However, "lefamulin is an important addition to the current antibiotic armamentarium, especially because bacterial pneumonia remains one of the most common indications for antibiotic use."