Pharmacodynamics of levofloxicin in patients with acute exacerbation of chronic bronchitis
M. Cazzola, M. G. Matera, G. Donnarumma, A. Salzillo, F. Marchetti, M. A. Tufano, F. Blasi (Naples, Verona, Milan, Italy)
Source: Annual Congress 2002 - Acute exacerbations of COPD: aetiology and therapy
Session: Acute exacerbations of COPD: aetiology and therapy
Session type: Thematic Poster Session
Number: 3379
Disease area: Airway diseases, Respiratory infections
Abstract Levofloxacin is a fluoroquinolone antimicrobial agent for which pharmacodynamic relationships between both the Cmax/MIC ratio and the AUC/MIC ratio and both clinical and microbiological outcomes have been developed. In this study we examined the relationship between the bacterial susceptibility to levofloxacin (MIC), the achieved levofloxacin serum and sputum concentrations, and in vivo eradication of the bacteria in 30 patients with acute exacerbations of chronic bronchitis and sufficient volumes of sputum to permit daily cultures. Patients were administered 500 mg of levofloxacin orally every 24 h for 7 days. Samples of venous blood and sputum for the determination of levofloxacin concentrations were collected on day 1 immediately prior to the dose and then at the following times postdosing: 1, 4, 8, 12, and 24 h. The mean peak concentration in serum (6.72 mg/L) was found at 1 h after administration, that in sputum (5.81 mg/L) at 4 h after administration. Levofloxacin was always detectable 24 h after administration. At post therapy, treatment was successful in 27 (90%) patients. Treatment was successful when levels in serum exceeded the MICs for isolated bacteria (9 S. pneumoniae , 8 H. influenzae , 6 M. catarrhalis , 4 H. parainfluenzae , 3 S. aureus ) for at least 12 h following the first dose, or the serum AUC/MIC ratio was higher that 40 and the sputum AUC/MIC ratio was higher that 30. Failures were associated with a serum Cmax/MIC ratio lower that 5:1 and a sputum Cmax/MIC ratio lower that 4:1.
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M. Cazzola, M. G. Matera, G. Donnarumma, A. Salzillo, F. Marchetti, M. A. Tufano, F. Blasi (Naples, Verona, Milan, Italy). Pharmacodynamics of levofloxicin in patients with acute exacerbation of chronic bronchitis. Eur Respir J 2002; 20: Suppl. 38, 3379
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