From the Guidelines
Moraxella infections are typically treated with amoxicillin-clavulanate (Augmentin) as the first-line treatment, usually prescribed at 625 mg three times a day for 14 days for adults, as recommended by the most recent guidelines 1.
Treatment Options
The treatment of Moraxella infections depends on the site and severity of the infection. According to the British Thoracic Society guideline for bronchiectasis in adults 1, the recommended first-line treatment for Moraxella catarrhalis is amoxicillin with clavulanic acid 625 mg three times a day for 14 days.
Alternative Treatments
Alternative treatments include:
- Clarithromycin 500 mg twice daily for 14 days
- Doxycycline 100 mg twice daily for 14 days
- Ciprofloxacin 500 mg or 750 mg twice daily for 14 days It's essential to note that many Moraxella strains produce beta-lactamase enzymes, making them resistant to plain amoxicillin or penicillin, which is why combination drugs containing beta-lactamase inhibitors are preferred.
Important Considerations
Treatment should be completed for the full prescribed duration, even if symptoms improve quickly, to prevent recurrence. Supportive measures like adequate hydration, rest, and over-the-counter pain relievers may help manage symptoms while the antibiotics work. If symptoms don't improve within 48-72 hours of starting antibiotics, follow-up with a healthcare provider is recommended as antibiotic resistance testing may be needed. The older guideline from 2001 1 is not considered due to the more recent and higher quality study from 2019 1.
From the FDA Drug Label
1.2 Community-Acquired Pneumonia: 7 to 14 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of community-acquired pneumonia due to ... Moraxella catarrhalis...
1.4 Acute Bacterial Sinusitis: 5 Day and 10 to 14 Day Treatment Regimens Levofloxacin tablets are indicated for the treatment of acute bacterial sinusitis due to ... Moraxella catarrhalis...
1.5 Acute Bacterial Exacerbation of Chronic Bronchitis Levofloxacin tablets are indicated for the treatment of acute bacterial exacerbation of chronic bronchitis due to ... Moraxella catarrhalis...
Treatment for Moraxella infection is levofloxacin as indicated in the drug label for the treatment of community-acquired pneumonia, acute bacterial sinusitis, and acute bacterial exacerbation of chronic bronchitis due to Moraxella catarrhalis 2.
1.1 Lower Respiratory Tract Infections – caused by beta-lactamase–producing isolates of ... Moraxella catarrhalis. 1.2 Acute Bacterial Otitis Media – caused by beta-lactamase–producing isolates of ... Moraxella catarrhalis. 1.3 Sinusitis – caused by beta-lactamase–producing isolates of ... Moraxella catarrhalis.
Alternatively, amoxicillin-clavulanate can be used to treat Moraxella infections, including lower respiratory tract infections, acute bacterial otitis media, and sinusitis due to beta-lactamase–producing isolates of Moraxella catarrhalis 3.
From the Research
Treatment for Moraxella Infection
The treatment for Moraxella infection typically involves the use of antimicrobial agents. According to 4, the isolates of Moraxella catarrhalis showed maximum resistance to cotrimoxazole, penicillin, and ampicillin, while susceptibility was maximum to cefotaxime, tetracycline, ciprofloxacin, erythromycin, amikacin, gentamycin, and cefazolin.
Antibiotic Therapy
- The choice of antibiotic therapy should be based on the sensitivity report for rapid response and recovery of patients 4.
- Amoxicillin-clavulanic acid is a first-choice treatment for respiratory tract infections caused by Moraxella catarrhalis, as well as Streptococcus pneumoniae and Haemophilus influenzae 5, 6.
- The use of duo-therapy with a combination of fluoroquinolone and cefmenoxime should be considered in cases nonresponsive to monotherapy, such as keratitis and bleb-associated infections 7.
Specific Treatment Options
- Cefotaxime, tetracycline, ciprofloxacin, erythromycin, amikacin, gentamycin, and cefazolin may be effective against Moraxella catarrhalis infections 4.
- Levofloxacin, tobramycin, ceftazidime, ceftriaxone, and cefazolin may be effective against Moraxella ocular infections 7.
- Amoxicillin-clavulanic acid may be effective against Moraxella catarrhalis infections, including those caused by beta-lactamase-producing organisms 8, 5, 6.