High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm.
Levofloxacin demonstrates concentration-dependent bactericidal activity most closely related to the pharmacodynamic parameters of the ratio of area under the concentration-time curve (AUC) to minimum inhibitory concentration (MIC) and the ratio of peak plasma concentration (C(max)) to MIC. Increasing the dose of levofloxacin to 750 mg exploits these parameters by increasing peak drug concentrations, allowing for a shorter course of treatment without diminishing therapeutic benefit. This was demonstrated in a multicenter, randomized, double-blind investigation that compared levofloxacin dosages of 750 mg per day for 5 days with 500 mg per day for 10 days for the treatment of mild to severe community-acquired pneumonia (CAP). In the clinically evaluable population, the clinical success rates were 92.4% (183 of 198 persons) for the 750-mg group and 91.1% (175 of 192 persons) for the 500-mg group (95% confidence interval, -7.0 to 4.4). Microbiologic eradication rates were 93.2% and 92.4% in the 750-mg and 500-mg groups, respectively. These data demonstrate that 750 mg of levofloxacin per day for 5 days is at least as effective as 500 mg per day for 10 days for treatment of mild-to-severe CAP.
Dunbar
Lala M
LM
Louisiana State University Medical Center, New Orleans, Louisiana, USA.
Wunderink
Richard G
RG
Habib
Michael P
MP
Smith
Leon G
LG
Tennenberg
Alan M
AM
Khashab
Mohammed M
MM
Wiesinger
Barbara A
BA
Xiang
Jim X
JX
Zadeikis
Neringa
N
Kahn
James B
JB
D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017714:Community-Acquired Infections / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008297:Male; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000008:administration & dosage* / Q000009:adverse effects; D011014:Pneumonia / Q000188:drug therapy*; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D064704:Levofloxacin; D015242:Ofloxacin