Full-course oral levofloxacin for treatment of hospitalized patients with community-acquired pneumonia.

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Serval ID
serval:BIB_E3C795740BC3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Full-course oral levofloxacin for treatment of hospitalized patients with community-acquired pneumonia.
Journal
European Journal of Clinical Microbiology & Infectious Diseases
Author(s)
Erard V., Lamy O., Bochud P.Y., Bille J., Cometta A., Calandra T.
ISSN
0934-9723
Publication state
Published
Issued date
02/2004
Peer-reviewed
Oui
Volume
23
Number
2
Pages
82-88
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Abstract
Most guidelines for the management of hospitalized patients with community-acquired pneumonia (CAP) recommend commencing therapy with intravenous antibiotics, primarily because of concern about absorption of oral antibiotics in acutely ill patients. However, patients who respond are rapidly switched to oral therapy, which has been shown to reduce costs and to shorten the length of stay. The aim of the present study was to determine whether a full course of oral antibiotics is as efficacious and as safe as intravenous-to-oral sequential antibiotic therapy for the treatment of hospitalized, non-ICU patients with CAP. In an open-labelled, controlled study, 129 hospitalized patients with CAP were randomly assigned in a 2:1 ratio to receive either a full course of oral levofloxacin (500 mg q12 h) or an intravenous-to-oral sequential therapy consisting of intravenous ceftriaxone (2 g q24 h) with or without clarithromycin (500 mg q12 h) followed by an oral antibiotic (a beta-lactam agent in the majority of patients). The primary study endpoint was the resolution of CAP; secondary endpoints included length of stay and overall mortality. CAP resolved in 72 of 79 (91.1%) patients in the levofloxacin group and in 34 of 37 (91.9%) patients in the intravenous-to-oral sequential therapy group (difference, -0.8%, 95%CI, -11.6-10.0). Median length of stay was 8 days (range, 2-74 days) in the levofloxacin group and 10 days (range, 3-29 days) in the intravenous-to-oral sequential therapy group ( P=0.28). Day 30 mortality rates were 1.3% (1 of 79) and 8.1% (3 of 37), respectively (difference, -6.8%, 95%CI, -16.0-2.3). Full-course oral levofloxacin is as efficacious and as safe as standard intravenous-to-oral sequential antibiotic therapy for the treatment of hospitalized patients with CAP.
Keywords
Administration, Oral, Adult, Aged, Aged, 80 and over, Community-Acquired Infections/diagnosis, Community-Acquired Infections/drug therapy, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Follow-Up Studies, Hospitalization, Hospitals, Teaching, Humans, Injections, Intravenous, Male, Middle Aged, Ofloxacin/administration & dosage, Pilot Projects, Pneumonia, Bacterial/drug therapy, Pneumonia, Bacterial/microbiology, Probability, Prospective Studies, Risk Assessment, Statistics, Nonparametric, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 13:55
Last modification date
14/02/2022 7:57
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