title: Once-daily, high-dose levofloxacin versus ticarcillin-clavulanate alone or followed by amoxicillin-clavulanate for complicated skin and skin-structure infections: a randomized, open-label trial.
abstract: This study tested whether levofloxacin, at a new high dose of 750 mg, was effective for the treatment of complicated skin and skin-structure infections (SSSIs). Patients with complicated SSSIs (n=399) were randomly assigned in a ratio of 1:1 to 2 treatment arms: levofloxacin (750 mg given once per day intravenously [iv], orally, or iv/orally) or ticarcillin-clavulanate (TC; 3.1 g given iv every 4-6 hours) followed, at the investigator's discretion, by amoxicillin-clavulanate (AC; 875 mg given orally every 12 hours). In the clinically evaluable population, therapeutic equivalence was demonstrated between the levofloxacin and TC/AC regimens (success rates of 84.1% and 80.3%, respectively). In the microbiologically evaluable population, the overall rate of eradication was 83.7% in the levofloxacin treatment group and 71.4% in the TC/AC treatment group (95% confidence interval, -24.3 to -0.2). Both levofloxacin and TC/AC were well tolerated. These data demonstrate that levofloxacin (750 mg once per day) is safe and at least as effective as TC/AC for complicated SSSIs.
authors.affiliation: Department of Infectious Diseases, Springfield Clinic, Springfield, IL 62703, USA. infectn@springfieldclinic.com
authors.forename: Donald R
authors.initials: DR
authors.lastname: Graham
authors.forename: David A
authors.initials: DA
authors.lastname: Talan
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Nichols
authors.forename: Christopher
authors.initials: C
authors.lastname: Lucasti
authors.forename: Michael
authors.initials: M
authors.lastname: Corrado
authors.forename: Nancy
authors.initials: N
authors.lastname: Morgan
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Fowler
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012871:Skin Diseases / Q000188:drug therapy*; D013982:Ticarcillin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D002969:Clavulanic Acids; D064704:Levofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; C043215:ticarcillin-clavulanic acid; D015242:Ofloxacin; D013982:Ticarcillin