PEFLOXACIN IN THE TREATMENT OF NOSOCOMIAL RESPIRATORY-TRACT INFECTIONS

The efficacy and safety of the fluoroquinolone pefloxacin was evaluate d in 55 patients with nosocomial respiratory tract infections. Eightee n patients had bronchiectasis, 14 had chronic obstructive pulmonary di sease, 9 had lung abscess, 6 had pneumonia, 3 had bronchial asthma wit h infection, 2 had interstitial lung disease with infection, and 1 pat ient each had empyema, infected lung cyst, and hydropneumothorax. All patients suffered from cough. Forty-two (76%) of the 55 patients had d yspnea, 33 (60%) had rhonchi, and 22 (40%) had fever. Klebsiella and P seudomonas species were isolated from the sputum of 18 and 17 patients , respectively, Two patients were infected with Acinetobacter, 3 with staphylococci, 2 with streptococci, 2 were infected with Streptococcus pneumoniae, and 1 each with Haemophilus influenzae, and Escherichia c oli. In 12 patients, no organisms were isolated from the sputum. All p atients were treated with pefloxacin 400 mg twice daily for 10 to 14 d ays. In 36 (84%) of the 43 patients with positive cultures, pefloxacin therapy eradicated the organisms. The organisms persisted in seven (1 6%) patients. Clinical cure was observed in 10 (18%) of the 55 patient s, improvement was seen in 39 (71%) patients, and failure occurred in 6 (11%) patients. Pefloxacin therapy did not affect biochemical values . One patient complained of mild headache, but this side effect was no t directly attributable to pefloxacin treatment. Pefloxacin should be considered as an alternative to multi-drug therapy for the treatment o f nosocomial respiratory tract infections.