Levofloxacin efficacy in the treatment of community-acquired legionellosis.
BACKGROUND
Although fluoroquinolones possess excellent in vitro activity against Legionella, few large-scale clinical trials have examined their efficacy in the treatment of Legionnaires disease. Even fewer studies have applied rigorous criteria for diagnosis of community-acquired Legionnaires disease, including culture of respiratory secretions on selective media.


METHODS
Data from six clinical trials encompassing 1,997 total patients have been analyzed to determine the efficacy of levofloxacin (500 mg qd or 750 mg qd) in treating patients with community-acquired pneumonia (CAP) due to Legionella.


RESULTS
Of the 1,997 total patients with CAP from the clinical trials, 75 patients had infection with a Legionella species. Demographics showed a large portion of these patients were < 55 years of age and nonsmokers. More than 90% of mild-to-moderate and severe cases of Legionella infection resolved clinically at the posttherapy visit, 2 to 14 days after treatment termination. No deaths were reported for any patient with Legionnaires disease treated with levofloxacin during the studies.


CONCLUSIONS
Levofloxacin was efficacious at both 500 mg for 7 to 14 days and 750 mg for 5 days. Legionnaires disease is not associated only with smokers, the elderly, and the immunosuppressed, but also has the potential to affect a broader demographic range of the general population than previously thought.
Yu
Victor L
VL
VAMC and University of Pittsburgh, Pittsburgh, PA, USA.
Greenberg
Richard N
RN
Zadeikis
Neringa
N
Stout
Janet E
JE
Khashab
Mohammed M
MM
Olson
William H
WH
Tennenberg
Alan M
AM
D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016952:Legionella pneumophila / Q000187:drug effects* / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000188:drug therapy*; D064704:Levofloxacin; D008297:Male; D015242:Ofloxacin / Q000008:administration & dosage*; D018570:Risk Assessment; D016896:Treatment Outcome
D064704:Levofloxacin; D015242:Ofloxacin