Moxifloxacin penetrates well into oromaxillary tissue and covers the causative pathogens that show an increasing resistance to standard
antibiotics. Clinical reports suggest that
moxifloxacin may be effective for the treatment of odontogenic
infections that can lead to serious complications. The objective of this prospective, randomized, double-blind, multicenter study was to compare the efficacies and safeties of
moxifloxacin and
clindamycin for the medical treatment of patients with gingival inflammatory infiltrates and as an adjuvant
therapy for patients with odontogenic
abscesses requiring surgical treatment. Patients received either 400 mg
moxifloxacin per os once daily or 300 mg
clindamycin per os four times daily for 5 days consecutively. The primary efficacy endpoint was the percent reduction in patients' perceived
pain on a visual analogue scale at days 2 to 3 from baseline. Primary analysis included 21
moxifloxacin- and 19
clindamycin-treated patients with infiltrates and 15
moxifloxacin- and 16
clindamycin-treated patients with
abscesses. The mean
pain reductions were 61.0% (standard deviation [SD], 46.9%) with
moxifloxacin versus 23.4% (SD, 32.1%) with
clindamycin (P = 0.006) for patients with infiltrates and 55.8% (SD, 24.8%) with
moxifloxacin versus 42.7% (SD, 48.5%) with
clindamycin (P = 0.358) for patients with
abscesses. A global efficacy assessment at days 2 to 3 and 5 to 7 showed faster clinical responses with
moxifloxacin in both
abscess and infiltrate patients. Rates of adverse events were lower in
moxifloxacin- than in
clindamycin-treated patients. In patients with inflammatory infiltrates,
moxifloxacin was significantly more effective in reducing
pain at days 2 to 3 of
therapy than
clindamycin. No significant differences between groups were found for patients with odontogenic
abscesses.