Methodology: 4/5
Usefulness: 2/5
Alexander E., et al. JAMA. 2019 Sep 27. doi: 10.1001/jama.2019.15468.
Editorial: Lefamulin-A New Antibiotic for Community-Acquired Pneumonia.
Question and Methods: LEAP-2 was a phase 3, double-blinded RCT to determine non-inferiority of early clinical response of an oral lefamulin to oral moxifloxacin in Community Acquired Bacterial Pneumonia (CABP).
Findings: Early clinical response rates were 90.8% with lefamulin and 90.8% with moxifloxacin (0.1%, -4.4% to infinity).
Limitations: Industry sponsored, outcomes dictated by regulatory bodies, extensive exclusion criteria, cost/availability of lefamulin.
Interpretation: Lefamulin is noninferior to moxifloxacin, however, the greater cost, availability of other antibiotics for CAP, higher incidence of GI side effects of lefamulin do not necessarily make it the first choice for CABP.
