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

29 March, 2018

Question 18

Were you able to identify any factors associated with increased risk of treatment failure in this group of patients? How would you stratify ABECB patients to ensure the optimum treatment is given to each group?

This is the first study to prospectively stratify patients by the presence or absence of risk factors for treatment failure. This study confirmed that if risk factors for treatment failure were present (FEV1 < 50% predicted, co-morbidity such as diabetes mellitus, congestive heart failure, chronic renal or liver disease, chronic O2 therapy, use of long term oral corticosteroids, or ≧ 4 exacerbations/year), poorer clinical and microbiological outcomes were seen independent of antibiotic choice compared to patients without these risk factors. Many guidelines recommend stratification of patients by the presence or absence of risk factors for treatment failure (8, 20, 22, 23). If any of these risk factors are present, treatment with a respiratory fluoroquinolone such as levofloxacin or amoxicillin/clavulanate is recommended.