Objective:To evaluate the efficacy and safety of sequential moxifloxacin therapy in the treatment of elderly patients with community-acquired pneumonia. Methods:One hundred and eighty-four elderly patients with community-acquired pneumonia were randomly divided into three groups. In group A(control group),moxifloxacin was administered by intravenous infusion,400 mg/250 ml once daily for 7~10 d. In group B(moxifloxacin sequential group),moxifloxacin was administered by intravenous infusion 400 mg/250 ml,once daily until to sequential switch time window,followed by oral administration at the same dose. The total treatment duration was also 7~10 days. In group C(combination sequential group),Cefuroxime was administered by intravenous infusion 3.0 g/250 ml,twice daily,with Azithromycin 500 mg/250 ml,once daily until to sequential switch time window,followed by oral administration of Cefuroxime tablet 250 mg,twice daily and Azithromycin table 500 mg,once daily. The total treatment duration was also 7~10 d. Results:The overall cure rates and efficacy rates were 67.2 % and 93.4 % in group A,65.5 % and 87.9 % in group B,44.7 % and 72.3% in group C,respectively. The bacterial clearance rates were 88.5 % in group A,85.2 % in group B,60.0 % in group C,respectively. There was no significant difference(P > 0.05) between group A and B,and there was significant difference(P < 0.05) between group B and C in the above results. Sequential switch time window were(2.2 ± 1.10)d in group B,(3.09 ± 1.23)d in group C,respectively(P < 0.05). The incidence of adverse drug reactions of three groups were 4. 9%,3.4 % and 13.8 %,respectively. There was no significant difference(P > 0.05) between group A and B,and there was significant difference(P < 0.05) between group B and C in the above results. Conclusion:Sequential therapy of moxifloxacin in treatment of elderly patients with community-acquired pneumonia was effective and safe.