Community Acquired Pneumonia (Sub-Category)

High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm

LM Dunbar
RG Wunderink
MP Habib
LG Smith
AM Tennenberg
et al



Levofloxacin demonstrates concentration-dependent bactericidal activity most closely related to the pharmacodynamic parameters of the ratio of area under the concentration-time curve (AUC) to minimum inhibitory concentration (MIC) and the ratio of peak plasma concentration (C(max)) to MIC.  Increasing the dose of levofloxacin to 750 mg exploits these parameters by increasing peak drug concentrations, allowing for a shorter course of treatment without diminishing therapeutic benefit.  This was demonstrated in a multicenter, randomized, double-blind investigation that compared levofloxacin dosages of 750 mg per day for five days with 500 mg per day for ten days for the treatment of mild to severe community-acquired pneumonia (CAP).  In the clinically evaluable population, the clinical success rates were 92.4% (183 of 198 persons) for the 750-mg group and 91.1% (175 of 192 persons) for the 500-mg group (95% confidence interval, -7.0 to 4.4).  Microbiologic eradication rates were 93.2% and 92.4% in the 750-mg and 500-mg groups, respectively.  These data demonstrate that 750 mg of levofloxacin per day for five days is at least as effective as 500 mg per day for ten days for treatment of mild-to-severe CAP.


PubMed Link to Article:

Dunbar LM, Wunderink RG, Habib MP, Smith LG, Tennenberg AM, Khashab MM, Wiesinger BA, Xiang JX, Zadeikis N, Kahn JB. High-dose, short-course levofloxacin for community-acquired pneumonia: a new treatment paradigm. Clin Infect Dis. 2003 Sep 15;37(6):752-60. Epub 2003 Aug 28. Erratum in: Clin Infect Dis. 2003 Oct 15;37(8):1147. PubMed PMID: 12955634.