OFLOXACIN VERSUS STANDARD THERAPY IN TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA REQUIRING HOSPITALIZATION

Community-acquired pneumonia occurs 3 to 4 million times per year in t he United States, accounting for about 500,000 hospitalizations annual ly. Empiric treatment is usually instituted because of a lack of early organism-specific diagnostic tests. This study compared empiric thera py with ofloxacin to standard antibiotic regimens (usually a beta-lact am with or without a macrolide) for patients hospitalized for communit y-acquired pneumonia. Therapy was administered to 298 patients (146 re ceiving ofloxacin and 152 receiving standard therapy); 227 patients (o floxacin, 109; standard treatment, 118) were evaluable for treatment e fficacy. The most common pyogenic respiratory pathogens were Haemophil us influenzae (30 isolates) and Streptococcus pneumoniae (24 isolates) . There was evidence of infection with either Mycoplasma pneumoniae (3 8 patients), Chlamydia pneumoniae (40 patients), or a Legionella sp. ( 8 patients) in a total of 79 patients (35%). The clinical success rate s were similar in both groups among evaluable patients (92%, ofloxacin ; 87%, standard therapy) and among patients with atypical respiratory pathogens (88%, ofloxacin; 81%, standard therapy). The mean numbers (/- the standard deviations) of intravenous doses of antibiotics were 7 .5 +/- 8.0 in the ofloxacin group and 18.4 +/- 18.5 in the standard th erapy group (P < 0.001); the mean number of oral doses of ofloxacin pe r patient was 19.7 +/- 11.2, compared with 30.2 +/- 16.0 oral antibiot ic doses in the standard therapy group (P < 0.001). All treatments wer e well tolerated and associated with no significant clinical or labora tory abnormalities. The findings of this study indicate that ofloxacin is active against traditional bacterial pathogens as well as the majo r atypical respiratory pathogens. When given as monotherapy for the em piric treatment of community-acquired pneumonia, ofloxacin is as effec tive as standard antimicrobial therapy.