title: [Efficacy and safety of levofloxacin in patients with nursing and healthcare-associated pneumonia].
abstract: Levofloxacin (LVFX) is one of respiratory quinolones with wide spectrum of antimicrobial efficacy for Gram-positive and -negative bacteria and also atypical bacteria, and 500 mg of intravenous LVFX infusion has recently been able to use once daily based on pharmacokinetics-pharmacodynamics in Japan. So far, there had been no reports of the prospective studies evaluating efficacy and safety of LVFX in patients with nursing and healthcare-associated pneumonia (NHCAP). This study was conducted to evaluate prospectively the efficacy and safety of LVFX in patients with NHCAP categories B and C (other antibacterial agents were allowed to use with LVFX) according to Japanese guideline for NHCAP by the Japanese Respiratory Society (JRS). LVFX 500 mg was intravenously administered once daily, and the clinical efficacy and safety were evaluated by clinical symptoms, peripheral blood laboratory findings and chest X-rays. Sixty-two patients (average age was 81.2 years old, female/male was 22/40) were firstly registered and evaluated for the safety of LVFX, and eventually 54 patients were enrolled for the evaluation of clinical efficacy of LVFX. The percentage of these 54 patients aged over 65 years old was 96.3%, NHCAP category B/C was 33/21. The efficacy of LVFX in all 54 patients evaluated was 85.2% (categories B/C of NHCAP was 81.8/90.5%). In addition, the efficacies of LVFX in each pneumonia severity category by A-DROP system by JRS in NHCAP patients were 100% in mild, 86.7% in moderate, 77.8% in severe/very severe. Nine patients (2 with liver dysfunction, 6 with renal dysfunction and 1 with thrombocytopenia) out of 62 patients were reported to have possible adverse effects of LVFX. All of the patients with liver and renal dysfunctions after starting LVFX administration demonstrated mild dysfunctions and continued LVFX treatment, and these dysfunctions normalized soon after cessation of LVFX. LVFX was changed to other antibacterial agent in one patient with thrombocytopenia, and also thrombocytopenia was normalized thereafter. In conclusion, LVFX is effective and relatively safe for categories B and C in patients with NHCAP.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yatera
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kawanami
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Sasahara
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hata
authors.forename: Keigo
authors.initials: K
authors.lastname: Uchimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Tachiwada
authors.forename: Keisuke
authors.initials: K
authors.lastname: Naito
authors.forename: Kaori
authors.initials: K
authors.lastname: Kato
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takaki
authors.forename: Ikuko
authors.initials: I
authors.lastname: Shimabukuro
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Keishi
authors.initials: K
authors.lastname: Oda
authors.forename: Kanako
authors.initials: K
authors.lastname: Hara
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Chojin
authors.forename: Yu
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Kentarou
authors.initials: K
authors.lastname: Akata
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ogoshi
authors.forename: Susumu
authors.initials: S
authors.lastname: Tokuyama
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Inoue
authors.forename: Shingo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Nishida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Orihashi
authors.forename: Yugo
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kawanami
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Taura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishimoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Obata
authors.forename: Yukikazu
authors.initials: Y
authors.lastname: Awaya
authors.forename: Tohru
authors.initials: T
authors.lastname: Tsuda
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yoshii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mukae
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003428:Cross Infection; D005260:Female; D006801:Humans; D007564:Japan; D064704:Levofloxacin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D015242:Ofloxacin; D011014:Pneumonia / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin; D015242:Ofloxacin