The Way Forward: High-Dose, Short-Course Levofloxacin Leads the Field

29 March, 2018

Question 8

What were the clinical success rates according to pathogen?

Individual pathogens identified by culture or serology revealed the most common respiratory pathogen to be S. pneumoniae, with 750 mg and 500 mg levofloxacin regimens achieving a 90.9% and 90.0% clinical success rate, respectively (Table 4). The most common atypical pathogen identified was M. pneumoniae, and the clinical success rates in patients infected with this pathogen were 95.3% for the 750 mg group and 94.4% for the 500 mg group.

Table 4. Levofloxacin 750 mg q.d. for 5 days for CAP: clinical success by pathogen a

Source/pathogen n/N (%) of patients b
Levofloxacin 750 mg
q.d. for 5 days
Levofloxacin 500 mg
q.d. for 10 days
Respiratory cultures (typical pathogens)    
  Haemophilus influenzae 12/13 (92.3) 13/14 (92.9)
  Haemophilus parainfluenzae 12/12 (100) 9/10 (90.0)
  Streptococcus pneumoniae 20/22 (90.9) 18/20 (90.0)
Serologies (atypical pathogens)    
  Chlamydia pneumoniae 20/22 (90.9) 16/16 (100)
  Legionella pneumophila 11/11 (100) 3/3 (100)
  Mycoplasma pneumoniae 41/43 (95.3) 34/36 (94.4)
a Identified in at least 5 clinically evaluable patients at the 7- to 14-day post-therapy visit. Clinical success includes cured and improved.
b Numbers shown in parentheses are percentages of patients infected with the pathogen who had a clinical response of cure or improvement divided by total number of patients infected with the pathogen.

Abbreviations: CAP = community-acquired pneumonia, q.d. = once daily.
Adapted from reference (50).