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Clinical Use of Levofloxacin for Intractable RTI in Outpatients

Hiroyuki Kobayashi, MD
First Internal Medicine, Kyorin University, Mitaka, Japan

This paper has dealt with the usefulness of levofloxacin in the treatment of intractable respiratory tract infections (RTI). Generally speaking, most intractable RTI form bacterial biofilm around the airway surface, which in turn demonstrates a resistance to antibiotics. As a result, it allows colonization by bacteria over an extended period. This results in both the relapse of an exacerbated infection due to floating bacteria freed from the biofilm, and tissue destruction by a harmful immune reaction, resulting from the antigenicity obtained by alginate, the basic substance in biofilm. In dealing with such infections, the significance of levofloxacin (LVFX) lies in its bactericidal activity against floating bacteria at the time of an exacerbated infection. Levofloxacin shows higher biofilm permeability against biofilm forming bacteria as compared with other quinolones, and we conclude that the combined use of LVFX with 14 or 15 element macrolides could be effective in treating intractable RTI.

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Last updated February 18, 1999.