Pefloxacin therapy for nosocomial infections in the intensive care unit.
Nosocomial infections occurring in an intensive care unit (ICU) are commonly caused by aerobic Gram-negative bacilli or Staphylococcus aureus, which are frequently multi-resistant and difficult to treat and contribute significantly to the patients' morbidity in the ICU. Pefloxacin, with its wide range of antimicrobial activity, lack of serious side-effects and advantageous kinetics, is a useful drug for use in this group of critically ill patients. Pefloxacin has achieved a greater than 70% clinical cure rate and a microbiological response of over 80% in cases of nosocomial pneumonia in the ICU. Failure and superinfection has occurred with the development of resistance, particularly in Pseudomonas aeruginosa in a small number of cases, but this can be prevented by combination antimicrobial therapy. Serious side-effects, including confusion, psychiatric disturbance and other neurological abnormalities were rare and resolved on withdrawal of the drug. Drug interactions occur with cimetidine and theophylline but are usually not clinically relevant; significant interaction with warfarin occurs and the dose of warfarin needs careful adjustment. Pefloxacin is a valuable drug for use in bacteriologically proven sensitive infections and combination with aminoglycosides or beta-lactam agents should prevent the development of resistance.
Potgieter
P D
PD
Department of Anaesthetics and Medicine, University of Cape Town, South Africa.
D003428:Cross Infection / Q000188:drug therapy* / Q000209:etiology; D006192:Haemophilus Infections / Q000188:drug therapy; D006193:Haemophilus influenzae; D006207:Half-Life; D006801:Humans; D007362:Intensive Care Units; D015366:Pefloxacin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011008:Pneumococcal Infections / Q000188:drug therapy; D013296:Streptococcus pneumoniae
D015366:Pefloxacin