Position of Levofloxacin in the Management of Bronchitis and Bronchiolitis
Pramod M. Shah, MD
Klinikum der Johann Wolfgang Goethe-Universität, Zentrum der Inneren Medizin, Medizinische Klinik III, Schwerpunkt Infektiologie, Frankfurt, Germany
Streptococcus pneumoniae, Haemophilus influenzae,and Moraxella catarrhalis are frequently identified in adults with acute exacerbations of chronic bronchitis (AECB) and purulent sputum. Increasing incidence of resistance in these organisms to penicillin and macrolides is reported worldwide. Six to 8 hours after a single 500 mg dose of levofloxacin, serum, tissue, and bronchial secretion concentrations were still at least twofold above the MIC90s for these three organisms. In a multicenter double-blind study of levofloxacin and cefuroxime-axetil in adult patients with AECB, the clinical cure rate for the levofloxacin group was 75%, compared to 63% for the cefuroxime-axetil group. Levofloxacin is a good alternative for treating AECB, especially in countries where S. pneumoniae resistance to penicillin, macrolides, and tetracyclines is increasing.