ONCE-A-DAY LEVOFLOXACIN IN THE TREATMENT OF MILD-TO-MODERATE AND SEVERE COMMUNITY-ACQUIRED PNEUMONIA IN ADULTS

The efficacy and safety of levofloxacin for the treatment of community -acquired pneumonia (CAP) was evaluated in 264 patients who exhibited infiltrates on chest roentgenograms and clinical signs and symptoms of CAP in an open-label trial. Patients were treated with levofloxacin 5 00 mg orally or intravenously once daily for 7-14 days. Of the 264 pat ients, 156 were outpatients; of the 108 inpatients, 40 (15%) met the c riteria for severe pneumonia. Of the 136 microbiologically evaluable p atients, 79 had a single ''typical'' pathogen, 31 had a single atypica l pathogen, 17 had both typical and atypical pathogens, and 19 had two or more typical pathogens. The most common pathogens (along with erad ication rates) were: Haemophilus influenzae (97.4%), Streptococcus pne umoniae (97.1%), and Chlamydia pneumoniae (95.7%). Eradication rates w ere 94.1% for patients with mild to moderate infections and 97.1% for those with severe infections. Of the 234 clinically evaluable patients , the overall clinical success rate was 95% (78% cured and 17% improve d). The most common drug-related adverse events were diarrhea (1.5%) a nd nausea (1.1%). Results suggest that, regardless of the number of pa thogens and the severity of pneumonia, levofloxacin 500 mg once daily, intravenously or orally, achieved an overall excellent eradication/cl inical success rate with minimal side effects. Levofloxacin thus warra nts consideration as initial monotherapy for CAP.