[Experience accumulated in hospital setting with levofloxacin, in monotherapy and in association therapy].
Levofloxacin possesses a wide antimicrobial spectrum which encompasses Gram positive (also including penicillin-resistant Streptococcus pneumoniae) and Gram negative, and atypical respiratory pathogens Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumoniae) as well. Comparative clinical studies (macrolides, beta-lactams, and other fluoroquinolones), have evidenced bacteriological and clinical efficacy in community-acquired pneumonia (CAP), acute exacerbation of chronic bronchitis, urinary tract infections, and skin and soft tissue infections. In clinical practice, levofloxacin in sequential therapy allowed to reduce length of stay, the efficacy being maintained unaltered. In severe pneumonia, or when a pseudomonas aetiology is suspected, an association therapy is suggested, although a reliable body of clinical evidence is still lacking. Recent in vitro studies showed a synergism between levofloxacin and imipenem against multiresistant Pseudomonas aeruginosa strains. A recent Italian clinical study evidenced the good efficacy and tolerability profile of prophylactic use of levofloxacin in neutropenic patients with cancer. Such a prophylaxis reduced number of febrile episodes, at a statistically significant level, and mortality (although at a not statistically significant level).
Petrosillo
Nicola
N
UOC Infezioni Sistemiche e Immunodepressioni, Istituto Nazionale per le Malattie Infettive L Spallanzani, IRCCS, Roma, Italy.
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000188:drug therapy* / Q000209:etiology; D017714:Community-Acquired Infections / Q000188:drug therapy; D003428:Cross Infection / Q000188:drug therapy*; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D006748:Hospital Departments; D006801:Humans; D064704:Levofloxacin; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications; D015242:Ofloxacin / Q000008:administration & dosage / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin