Use of Levofloxacin in the Treatment of Respiratory Tract Infections in an Era of Increasing Resistance:
A Review of International Surveillance and TRUST Data
Mark E. Jones, PhDa, Clyde Thornsberry, PhDb, James A. Karlowsky, PhDb, Daniel F. Sahm, PhDb
Focus Technologies, Inc., Hilversum, the Netherlandsa, Herndon, Virginia, USAb
Surveillance studies to monitor the susceptibility of major pathogens of the respiratory tract to various antibacterial agents have been carried out in Europe, Asia, South Africa, North and South America and the US. Together, these studies tested more than 15,000 strains of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and the atypical pathogens, Legionella pneumophila, Mycoplasma pneumoniae and Chlamydia pneumoniae. These studies confirmed the spread of resistance to penicillins, macrolides, and trimethoprim-sulfamethoxazole among pneumococcal isolates around the world and also revealed the variability seen in different countries. Multidrug resistance was also commonly detected, although most of these phenotypes remained susceptible to levofloxacin. Resistance to levofloxacin was rare in most countries, but some resistance was seen in isolates from Asia. These studies emphasize the necessity of monitoring the susceptibility of respiratory pathogens to antibacterials and illustrate the importance of such results in the guidance of empiric therapy.