Early discharge of hospitalised patients with community-acquired urosepsis when treated with levofloxacin in sequential therapy.
OBJECTIVE
To compare the sequential therapy with levofloxacin with a standard treatment in the management of urosepsis.


METHODS
It was a multicenter, randomized, open label, pilot trial in community acquired urosepsis carried out in 7 hospitals. Levofloxacin administered 500 mg twice a day intravenously and then orally was compared to piperacillin/tazobactam 4 g/0.5 g three times a day, both in combination with amikacin 7.5 mg/Kg twice a day, for a maximum of 14 days. Amikacin could be suspended between day 3-7.


RESULTS
Both treatments were efficacious and well tolerated in the 47 enrolled patients, even tough the time to clinical stability was shorter in the levofloxacin treated patients (3.9 vs. 4.9 days). In the levofloxacin group the sequential therapy was performed in 19 (82.6%) cases, after 4.8 +/- 1.7 days of parenteral administration (100% in the per-protocol population after 5.1 +/- 1.9 days).


CONCLUSIONS
The implementation of the sequential therapy in the levofloxacin group allowed an early hospital discharge in patients with urosepsis and a cost saving in the hospital perspective.
Concia
Ercole
E
Department of Infectious Diseases, Policlinico G.B. Rossi, University of Verona, Verona, Italy.
Marchetti
Federico
F
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage*; D017714:Community-Acquired Infections / Q000188:drug therapy; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D064704:Levofloxacin; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage*; D010351:Patient Discharge; D010397:Penicillanic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D010865:Pilot Projects; D010878:Piperacillin / Q000008:administration & dosage; D000077725:Piperacillin, Tazobactam Drug Combination; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D000077725:Piperacillin, Tazobactam Drug Combination; D064704:Levofloxacin; D010397:Penicillanic Acid; D015242:Ofloxacin; D010878:Piperacillin