Question 3

Are these advantageous pharmacologic features present in patients with acute bacterial exacerbations of chronic obstructive pulmonary disease (ABECOPD)?

Yes, a study investigating the PD features of levofloxacin in 30 ABECOPD patients found that the drug remained detectable 24 hours after administration, with successful treatment in 90% when the AUC_0-24/MIC ratio was > 125 for serum and > 100 for sputum, values that can be used as predictors of outcome (4). In addition, PD assessment of high-dose levofloxacin against P. aeruginosa demonstrated that levofloxacin and ciprofloxacin demonstrated similar antimicrobial activity against the two strains tested with gatifloxacin having lesser activity (5). In addition, the high-dose levofloxacin was the only regimen that achieved or closely approached the target PD parameters in a comparison of gatifloxacin, ciprofloxacin and levofloxacin.