Comparative Analysis of Length of Stay, Total Costs, and Treatment Success between Intravenous Moxifloxacin 400 mg and Levofloxacin 750 mg among Hospitalized Patients with Community-Acquired Pneumonia

Objective:  This study aimed to evaluate the length of stay (LOS), costs, and treatment consistency among patients hospitalized with community-acquired pneumonia (CAP) initially treated with intravenous (IV) moxifloxacin 400 mg or IV levofloxacin 750 mg.
Methods:  Adults with CAP receiving IV moxifloxacin or IV levofloxacin for ≥3 days were identified in the Premier Perspective comparative database. Primary outcomes were LOS and costs. Secondary outcomes included treatment consistency, which was defined as 1) no additional IV moxifloxacin or levofloxacin after ≥1 day off study drug; 2) no switch to another IV antibiotic; and 3) no addition of another IV antibiotic.
Results:  A total of 7720 patients met inclusion criteria (6040 receiving moxifloxacin; 1680 receiving levofloxacin). Propensity matching created two cohorts (1300 patients each) well matched for demographic, clinical, hospital, and payor characteristics. Before the patients were matched, mean LOS (5.87 vs. 5.46 days; P  = 0.0004) and total costs per patient ($7302 vs. $6362; P  < 0.0001) were significantly greater with moxifloxacin. After the patients were matched, mean LOS (5.63 vs. 5.51 days; P  = 0.462) and total costs ($6624 vs. $6473; P  = 0.476) were comparable in both cohorts. Treatment consistency was higher for moxifloxacin before (81.0% vs. 78.9%; P  = 0.048) and after matching (82.8% vs. 78.0%; P  = 0.002).
Conclusions:  In-hospital treatment of CAP with IV moxifloxacin 400 mg or IV levofloxacin 750 mg was associated with similar hospital LOS and costs in propensity-matched cohorts.