title: Concentrations of levofloxacin (HR 355) in the respiratory tract following a single oral dose in patients undergoing fibre-optic bronchoscopy.
abstract: Concentrations of levofloxacin were measured in bronchial biopsies, alveolar macrophages (AM), epithelial lining fluid (ELF) and serum following a single oral dose. Concentrations were measured by a microbiological assay method. A total of 35 patients undergoing fibre-optic bronchoscopy were studied. Mean serum, AM, ELF and biopsy concentrations were as follows. 0.5 h: 4.73 mg/L, 19.1 mg/L, 4.74 mg/L and 4.3 mg/kg; 1 h: 6.6 mg/L, 32.5 mg/L, 10.8 mg/L and 8.3 mg/kg; 2 h: 4.9 mg/L, 41.9 mg/L, 9.0 mg/L and 6.5 mg/kg; 4 h: 4.1 mg/L, 27.7 mg/L, 10.9 mg/L and 6.0 mg/kg; and 6-8 h: 4.0 mg/L, 38.4 mg/L, 9.6 mg/L and 4.0 mg/kg respectively. Mean serum and AM concentrations at 12-24 h were 1.2 and 13.9 mg/L respectively (concentrations in biopsy and ELF were only measurable in three of the six patients). These concentrations exceed the MIC90s of the common respiratory pathogens, Haemophilus influenzae (0.015 mg/L), Moraxella catarrhalis (0.06 mg/L) and Streptococcus pneumoniae (1 mg/L) and suggest that levofloxacin should be efficacious in the treatment of community- and hospital-acquired respiratory infection.
authors.affiliation: Department of Medical Microbiology, City Hospital NHS Trust, Birmingham, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Andrews
authors.forename: D
authors.initials: D
authors.lastname: Honeybourne
authors.forename: G
authors.initials: G
authors.lastname: Jevons
authors.forename: N P
authors.initials: NP
authors.lastname: Brenwald
authors.forename: B
authors.initials: B
authors.lastname: Cunningham
authors.forename: R
authors.initials: R
authors.lastname: Wise
mesh_terms: D000284:Administration, Oral; D000890:Anti-Infective Agents / Q000493:pharmacokinetics*; D001706:Biopsy; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D064704:Levofloxacin; D008168:Lung / Q000378:metabolism*; D008297:Male; D015242:Ofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D012141:Respiratory Tract Infections / Q000188:drug therapy*
chemical_list: D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin