Question 12

You used a shorter duration of therapy with levofloxacin – what was your rationale for this?

Fluoroquinolones are concentration-dependent bacterial killers. The higher the dose, the more rapid and more efficient the bacterial killing. Accordingly, if higher doses can be tolerated, improved bacterial killing is the result. This usually translates into more rapid patient recovery. Since the bacteria are killed more rapidly and extensively, shorter duration of therapy is possible and indeed, desirable. Several studies have confirmed that shorter (5-day) courses of treatment with fluoroquinolones in pneumonia and acute bacterial sinusitis are as good as more prolonged treatment courses with lower doses (18, 19).