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Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia.
Curr Med Res Opin. 2004 Sep; 20(9):1473-81.CM

Abstract

OBJECTIVE

To evaluate the time to symptom resolution and i.v.-to-p.o. transition in community-acquired pneumonia (CAP) patients treated with 750 mg or 500 mg levofloxacin.

RESEARCH DESIGN

A retrospective, subset analysis of a multicenter, randomized, double-blind, controlled trial comparing 750 mg levofloxacin for 5 days to 500 mg levofloxacin for 10 days for the treatment of CAP.

PATIENTS AND METHODS

A total of 528 CAP patients were included. Baseline symptoms were re-evaluated on Day 3 of therapy, and time to i.v.-to-p.o. transition was recorded for inpatients.

RESULTS

For the overall population, 67.4% of patients receiving 750 mg levofloxacin had resolution of fever by Day 3 of therapy, compared to 54.6% of 500 mg treated patients (P = 0.006). Patients who started on 750 mg levofloxacin i.v. (N = 108) transitioned to p.o. in an average of 2.68 days while those starting on 500 mg i.v. (N = 124) transitioned in 2.95 days (P = 0.144). The median time for i.v.-to-p.o. switch was 2.35 days and 2.75 days for patients receiving 750 mg and 500 mg levofloxacin, respectively (P = 0.098, log rank test). By Day 3 of therapy, 68% of patients receiving the 750 mg dose had transitioned from i.v. to p.o. levofloxacin, compared with 61% of the 500 mg group (P = 0.280). The safety profiles were comparable for the two regimens.

CONCLUSIONS

The 750 mg levofloxacin dose resulted in a greater proportion of patients with resolution of CAP symptoms by Day 3 when compared with 500 mg therapy. Consequently, the 750 mg regimen trended toward more rapid transition to p.o., potentially resulting in lower overall drug costs. Time to switch from i.v. to p.o. was determined by the investigators' discretion rather than a set protocol. Additionally, length of stay data was not collected in this study, which can significantly impact overall healthcare costs. Further research is required to fully understand the economic impact of the 750 mg, 5-day levofloxacin regimen.

Authors+Show Affiliations

Northeastern Ohio Universities College of Medicine, Rootstown, OH, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15383197

Citation

File, Thomas M., et al. "Clinical Implications of 750 Mg, 5-day Levofloxacin for the Treatment of Community-acquired Pneumonia." Current Medical Research and Opinion, vol. 20, no. 9, 2004, pp. 1473-81.
File TM, Milkovich G, Tennenberg AM, et al. Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia. Curr Med Res Opin. 2004;20(9):1473-81.
File, T. M., Milkovich, G., Tennenberg, A. M., Xiang, J. X., Khashab, M. M., & Zadeikis, N. (2004). Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia. Current Medical Research and Opinion, 20(9), 1473-81.
File TM, et al. Clinical Implications of 750 Mg, 5-day Levofloxacin for the Treatment of Community-acquired Pneumonia. Curr Med Res Opin. 2004;20(9):1473-81. PubMed PMID: 15383197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical implications of 750 mg, 5-day levofloxacin for the treatment of community-acquired pneumonia. AU - File,Thomas M,Jr AU - Milkovich,Gary, AU - Tennenberg,Alan M, AU - Xiang,Jim X, AU - Khashab,Mohammed M, AU - Zadeikis,Neringa, PY - 2004/9/24/pubmed PY - 2005/1/27/medline PY - 2004/9/24/entrez SP - 1473 EP - 81 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 9 N2 - OBJECTIVE: To evaluate the time to symptom resolution and i.v.-to-p.o. transition in community-acquired pneumonia (CAP) patients treated with 750 mg or 500 mg levofloxacin. RESEARCH DESIGN: A retrospective, subset analysis of a multicenter, randomized, double-blind, controlled trial comparing 750 mg levofloxacin for 5 days to 500 mg levofloxacin for 10 days for the treatment of CAP. PATIENTS AND METHODS: A total of 528 CAP patients were included. Baseline symptoms were re-evaluated on Day 3 of therapy, and time to i.v.-to-p.o. transition was recorded for inpatients. RESULTS: For the overall population, 67.4% of patients receiving 750 mg levofloxacin had resolution of fever by Day 3 of therapy, compared to 54.6% of 500 mg treated patients (P = 0.006). Patients who started on 750 mg levofloxacin i.v. (N = 108) transitioned to p.o. in an average of 2.68 days while those starting on 500 mg i.v. (N = 124) transitioned in 2.95 days (P = 0.144). The median time for i.v.-to-p.o. switch was 2.35 days and 2.75 days for patients receiving 750 mg and 500 mg levofloxacin, respectively (P = 0.098, log rank test). By Day 3 of therapy, 68% of patients receiving the 750 mg dose had transitioned from i.v. to p.o. levofloxacin, compared with 61% of the 500 mg group (P = 0.280). The safety profiles were comparable for the two regimens. CONCLUSIONS: The 750 mg levofloxacin dose resulted in a greater proportion of patients with resolution of CAP symptoms by Day 3 when compared with 500 mg therapy. Consequently, the 750 mg regimen trended toward more rapid transition to p.o., potentially resulting in lower overall drug costs. Time to switch from i.v. to p.o. was determined by the investigators' discretion rather than a set protocol. Additionally, length of stay data was not collected in this study, which can significantly impact overall healthcare costs. Further research is required to fully understand the economic impact of the 750 mg, 5-day levofloxacin regimen. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/15383197/Clinical_implications_of_750_mg_5_day_levofloxacin_for_the_treatment_of_community_acquired_pneumonia_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079904X2556 DB - PRIME DP - Unbound Medicine ER -