Comparative in vitro Activity of Levofloxacin and Ciprofloxacin against Bacterial Isolates from Neutropenic Patients

Bonaventura, Giovanni Di; D’Antonio, Domenico; Catamo, Giovanni; D’Ercole, Simonetta; Piccolomini, R

doi:10.1159/000064918

Cited by 6 publications

(2 citation statements)

References 19 publications

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“…In particular, the levofloxacin activity against P. aeruginosa was comparable to that of ciprofloxacin, whereas the activity of levofloxacin against S. maltophilia, an emerging multiresistant pathogen, was better compared to the other drugs tested. This behavior has already been widely described [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 53%

In vitro Activity of Levofloxacin against Recent Gram-Negative Nosocomial Pathogens

et al. 2005

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The objective of our study was to evaluate the in vitro activity of levofloxacin in comparison with other antibiotics (coamoxiclav, ceftriaxone, ceftazidime, meropenem, aztreonam, ciprofloxacin and netilmicin) against about 500 Gram-negative nosocomial microorganisms, isolated during 2003. The bactericidal activities (minimal bactericidal activity and killing curve) of levofloxacin and the other antibiotics were also evaluated. The results confirm the excellent in vitro activity of levofloxacin against multiresistant nosocomial Gram-negative pathogens, including the 73 extended spectrum β-lactamase producer strains (90% of Escherichia coli, Enterobacter cloacae and Klebsiella pneumoniae were inhibited at 0.5 mg/l). Of particular interest is its susceptibility and bactericidal activity against Stenotrophomonas maltophilia strains. In conclusion, due to the favorable pharmacokinetics and pharmacodynamics of the molecule, associated with its safety, levofloxacin may represent a valid therapeutic option in the treatment of severe Gram-negative nosocomial infections.

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Section: Discussionmentioning

confidence: 53%

In vitro Activity of Levofloxacin against Recent Gram-Negative Nosocomial Pathogens

et al. 2005

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“…Fluoroquinolones which seem to be very promising agents for the management of S. maltophilia infections with gatifloxacin, moxifloxacin, gemifloxacin and levofloxacin showing better in vitro activity against S. maltophilia strains than ciprofloxacin, inhibited only 12% of the isolates (14)(15)(16). E-test revealed 52% of susceptibility to the same agent.…”

Section: However the Highest Percentage Of Susceptibility To This Agementioning

confidence: 99%

Discrepancies between Various Methods in Susceptibility Testing and Epidemiological Analysis of Stenotrophomonas maltophilia Clinical Isolates

Masgala¹,

Galani²,

Souli³

et al. 2010

Cent Eur J Public Health

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The susceptibility of 25 Stenotrophomonas maltophilia (S. maltophilia) clinical isolates to four different antimicrobials (trimethoprim/sulfomethoxazole, piperacillin/tazobactam, ceftazidime, ciprofloxacin) were investigated by disk diffusion, E-test and commercial Sensititre and PASCO broth microdilution techniques. Discrepancies between the results of broth microdilution and the other methods studied were characterized as very major, major and minor errors. Using the broth microdilution as the reference method, 24% of the isolates were found susceptible to trimethoprim/ sulfamethoxazole, 24% to ceftazidime, 0% to piperacillin/tazobactam and 12% to ciprofloxacin. Good correlation was observed between the two broth microdilution Sensititre and PASCO for all antibiotics tested. Disc diffusion and E-test generated inconsistent results for all agents except trimethoprim/sulfamethoxazole. A great genomic diversity was demonstrated within the S. maltophilia strains tested. Although our results confirm that trimethoprim-sulfamethoxazole had some in vitro activity against S. maltophilia, further clinical studies are necessary to evaluate the clinical efficacy of these compounds for the treatment of S. maltophilia infections, since no randomized controlled trials have been carried out and no correlation between the clinical response and susceptibility testing results has been reported. Furthermore, the high genomic diversity observed in the S. maltophilia strains indicates the need for careful epidemiological evaluation especially in nosocomial outbreaks.

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Once-Daily Oral Levofloxacin Monotherapy versus Piperacillin/Tazobactam Three Times a Day: A Randomized Controlled Multicenter Trial in Patients with Febrile Neutropenia

et al. 2004

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A prospective, randomized, controlled multicenter trial was performed to evaluate the efficacy and safety of once-daily oral monotherapy with 500 mg levofloxacin in comparison with 4.5 g piperacillin/tazobactam 3 times a day in patients with low-risk febrile neutropenia. Low risk was defined by oral temperature > or = 38.5 degrees C on one occasion or > or = 38.0 degrees C twice within 24 hours and granulocytopenia < or = 500/microL for less than 10 days. The primary end point was defined as defervescence after 72 hours followed by at least 7 afebrile days. Secondary end points were overall response, time to defervescence, survival on day 30, and toxicity. Thirty-four episodes were included. Fever of unknown origin accounted for 26 (76.5%) of the episodes, microbiologically defined infection for 5 (14.7%) of the episodes, and clinically defined infection for 3 (8.8%) of the episodes. On an intent-to-treat basis, all episodes were evaluable for the primary end point. Levofloxacin and piperacillin/tazobactam were successful after 72 hours of treatment in 76.5% and 88.3% of the episodes. Overall response was achieved in 94.1% and 100% of the episodes, respectively. One inpatient in the oral treatment group died of septic shock without identification of a causative pathogen. A larger phase III trial is warranted to further evaluate the lack of inferiority of the oral monotherapy regimen versus standard intravenous therapy.

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Comparative in vitro Activity of Levofloxacin and Ciprofloxacin against Bacterial Isolates from Neutropenic Patients

Cited by 6 publications

References 19 publications

In vitro Activity of Levofloxacin against Recent Gram-Negative Nosocomial Pathogens

In vitro Activity of Levofloxacin against Recent Gram-Negative Nosocomial Pathogens

Discrepancies between Various Methods in Susceptibility Testing and Epidemiological Analysis of Stenotrophomonas maltophilia Clinical Isolates

Once-Daily Oral Levofloxacin Monotherapy versus Piperacillin/Tazobactam Three Times a Day: A Randomized Controlled Multicenter Trial in Patients with Febrile Neutropenia

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