The Role of 750 mg Once-Daily Levofloxacin in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Diseases

29 March, 2018

Question 17

Could you comment on the advantages/disadvantages of levofloxacin compared to other agents, apart from amoxicillin-clavulanate in the treatment of ABECB (e.g., cefuroxime axetil, clarithromycin, other fluoroquinolones)?

The advantages of levofloxacin compared to other antibacterial classes are the excellent bacterial eradication rates, improved clinical outcomes compared to cephalosporins and excellent safety profile. The efficacy of this agent compared to other fluoroquinolones has not been tested in head to head trials in ABECB but my sense is that the respiratory fluoroquinolones would be similar to each other in clinical efficacy. Levofloxacin has been used for this indication longer than any other respiratory fluoroquinolone and the safety of the drug is well established. Current clinical trials suggest that the 750 mg dose is just as safe as the 500 mg dose.