Answer 18: Levofloxacin versus azithromycin/ceftriaxone in CAP

20 June, 2018

 

 

 

Results from another important clinical trial support the efficacy of levofloxacin in CAP. This study assessed the efficacy and tolerability of levofloxacin monotherapy and azithromycin and ceftriaxone combination therapy in hospitalized adults with moderate to severe CAP. Ceftriaxone was included in the initial regimen to ensure coverage against pneumococcal bacteremia. The total duration of therapy was a minimum of 10 days in both treatment groups. 236 patients were enrolled, with 110 patients in the levofloxacin group and 114 in the azithromycin group evaluated. Following treatment, the clinical success rate (cured + improved) was 94.1% in the levofloxacin group and 92.3% in the azithromycin group. The post-therapy microbiologic eradication rates were 89.5% for levofloxacin and 92.3% for azithromycin. Levofloxacin was well tolerated, with an overall incidence of drug-related adverse events of 5.3% compared to 9.3% for azithromycin. In these hospitalized patients with moderate to severe CAP, levofloxacin monotherapy was at least as effective as a combination regimen of azithromycin and ceftriaxone.