Levofloxacin 500mg once daily versus cefuroxime 250mg twice daily in patients with acute exacerbations of chronic obstructive bronchitis: clinical efficacy and exacerbation-free interval

Petitpretz, P; Choné, C.; Trémolières, François

doi:10.1016/j.ijantimicag.2006.11.033

Cited by 17 publications

(20 citation statements)

References 20 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study of 689 subjects with AECB randomly assigned to receive either levofloxacin (500 mg daily) or cefuroxime axetil (250 mg tablet twice daily) for 10 days demonstrated similar efficacy for levofloxacin (94.6%) and cefuroxime (93.8%) [41]. When perprotocol patients were evaluated, the time when 25% of the population would relapse with another AECB event was 93 days for levofloxacin-treated patients and 81 days for cefuroxime-treated patients (p = 0.756) [41].…”

Section: Use Of Fluoroquinolones In Aecb In the Elderlymentioning

confidence: 99%

“…When perprotocol patients were evaluated, the time when 25% of the population would relapse with another AECB event was 93 days for levofloxacin-treated patients and 81 days for cefuroxime-treated patients (p = 0.756) [41]. Subgroup ana lysis of clinical cure demonstrated no significant difference in efficacy between levofloxacin or cefuroxime for those older than 65 years of age (93.7 vs 92%, respectively) or for those 65 years of age or less (95.7 vs 92.6%, respectively) [41].…”

Section: Use Of Fluoroquinolones In Aecb In the Elderlymentioning

confidence: 99%

See 1 more Smart Citation

Antibiotic therapy in elderly patients with acute exacerbation of chronic bronchitis

Albertson¹,

Chan²

2009

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

Chronic bronchitis (CB) is a critical component of chronic obstructive pulmonary disease (COPD). Emphysema, reversible airway disease and bronchiectasis also contribute to COPD. Elderly patients are at increased risk for COPD and its components - emphysema, CB and bronchiectasis. In addition, older patients are at increased risk for resistant organisms during episodes of acute exacerbation of CB (AECB). These organisms include the more common bacteria implicated in AECB, such as Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae, and less common nonenteric, Gram-negative organisms such as Pseudomonas aeruginosa. Risk-stratified antibiotic treatment guidelines for AECB appear to be useful, although they have not been prospectively validated for the general CB population, and especially not in the elderly CB population. Many of the AECB treatment guidelines that are stratified based on risk factors have recommended that the oral respiratory fluoroquinolone antibiotics (gemifloxacin, levofloxacin and moxifloxacin) play a second-line but pivotal role, particularly in patients who have failed initial antibiotic treatment for simple CB or as initial treatment for complicated CB.

show abstract

Section: Use Of Fluoroquinolones In Aecb In the Elderlymentioning

confidence: 99%

Section: Use Of Fluoroquinolones In Aecb In the Elderlymentioning

confidence: 99%

Antibiotic therapy in elderly patients with acute exacerbation of chronic bronchitis

Albertson¹,

Chan²

2009

Expert Review of Respiratory Medicine

View full text Add to dashboard Cite

show abstract

“…76 The treatment groups were similar with respect to patients' age (mean = 52.9 years), severity of illness (APACHE II score = 15.0), and duration of mechanical ventilation before the onset of VAP (mean = 8.8 days). (87) 88% (91) 80% (84) NR NR NR 86% (97) 82% (105) 85% (20) 96% (23) 85% (148) 88% (152) 86% e (49) 78% e (37) 93% (143) 79% (120) 90% (151) 82% (126)…”

Section: Hospital-acquired/nosocomial Pneumoniamentioning

confidence: 99%

“…90 Treatment with levofl oxacin has been shown to reduce need for hospitalizing chronic bronchitis patients during treatment of their acute bacterial exacerbation (P = 0.02 vs. standard therapy comprised of clarithromycin, cefuroxime, or amoxicillin/clavulanate) 98 and prolong the posttreatment infection-free interval. 93,97 In a study of short-course treatment of acute bacterial exacerbation in patients with chronic bronchitis, after stratifying patients by severity of underlying disease, Martinez et al randomized uncomplicated patients to levofl oxacin 750 mg once daily for 3 days or azithromycin once daily for 5 days and complicated patients to levofl oxacin 750 mg once for 5 days or amoxicillin/clavulanate 875/125 mg twice daily for 10 days. 95 The clinical response rates for the study antibiotics within each disease severity sub-group were similar to one another (Table 6).…”

Section: Acute Bacterial Exacerbation Of Chronic Bronchitis (Abecb)mentioning

confidence: 99%

“…The foundation for the safety experience with levofl oxacin was laid during clinical trials (Ͼ7,000 patients) in which adverse events, laboratory testing, vital (296) 98% (157) 97% (165) 96% (157) 93% (165) Levofl oxacin 250 mg qd po × 7-10 days (232) Lomefl oxacin 400 mg qd po × 14 days (229) 93% (171) 89% (165) 95% (171) 92% (165) Levofl oxacin 250 mg qd po × 7-10 days (124) Ciprofl oxacin 500 mg bid po × 10 days (80) Lomefl oxacin 400 mg qd po × 14 days (55) 93% (89) 95% (58) 95% (39) 94% (89) 94% h (97) Levofl oxacin 750 mg qd po and/or IV × 5 days j (146) Ciprofl oxacin 400 mg IV and/or 500 mg po bid × 10 days j (165) 94% (80) 88% ( a Clinical success was defi ned as cure or improvement of symptoms, and bacteriological eradication was defi ned as proven or presumed eradication of the causative pathogens(s), both in microbiologically evaluable patients. The primary endpoint was bacteriological eradication, which was assessed at 5-30 post-treatment in the chronic bacterial prostatitis studies and 5-9 days post-treatment (0-2 days post-treatment for ciprofl oxacin 102,105 ) in the UTI studies.…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

See 1 more Smart Citation

A Review of Levofloxacin for the Treatment of Bacterial Infections

Noel

2009

Clinical Medicine. Therapeutics

View full text Add to dashboard Cite

Abstract:Completing its initial phases of drug development in the mid 1990s as the one of the fi rst fl uoroquinolones that could be used with confi dence to treat respiratory tract infections, levofl oxacin went on to become one of the most widely prescribed antibiotics in the world. Available in both oral (po) and intravenous (IV) formulations and with characteristics of over 90% bioavailability, distribution into both extracellular and intracellular pulmonary compartments, highly predictable pharmacokinetics with over 90% of the drug being excreted unchanged in urine, and reliable activity against a broad spectrum of clinically important pathogens, levofl oxacin has been used successfully to treat patients with a variety of serious infectious diseases as well as common infections most often treated outside of the hospital setting. Results of clinical trials involving patients with respiratory tract, urinary tract, and skin infections have consistently shown rates of clinical success and bacteriological eradication that were comparable to other widely used broad-spectrum agents. Regimens of levofl oxacin, initially involving total daily doses of 250 mg to 500 mg, but more recently regimens involving 750 mg doses, have been shown to be safe and effective. Nearly a decade and a half of clinical experience has defi ned a safety and tolerability profi le that permits data-driven assessment of the risks and benefi ts of using levofl oxacin. As resistance to currently available fl uoroquinolones has emerged, the clinical value of levofl oxacin deserves continued evaluation. However, consistently high rates of susceptibility of clinically important bacteria, especially among those bacteria that commonly cause respiratory tract infections, such as Streptococcus pneumoniae and Haemophilus infl uenzae, suggest that this agent will continue to be a widely used well past the 20-year anniversary of its introduction into the antibacterial armamentarium.

show abstract

Antibiotics for treatment and prevention of exacerbations of chronic obstructive pulmonary disease

Wilson

Sethi

Anzueto

et al. 2013

Journal of Infection

View full text Add to dashboard Cite

Acute exacerbations (AE) can be recurrent problems for patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) increasing morbidity and mortality. Evidence suggests that ≥50% of acute exacerbations involve bacteria requiring treatment with an antibiotic which should have high activity against the causative pathogens. However, sputum analysis is not a pre-requisite for antibiotic prescription in outpatients as results are delayed and patients are likely to be colonised with bacteria in the stable state. Clinicians rely on the clinical symptoms, sputum appearance and the patient's medical history to decide if an AE-COPD should be treated with antibiotics. This article reviews the available data of antibiotic trials in AE-COPD. Management of frequent exacerbators is particularly challenging for physicians. This may include antibiotic prophylaxis, especially macrolides because of anti-inflammatory properties; though successful in reducing exacerbations, concerns about resistance development remain. Inhalation of antibiotics achieves high local concentrations and minimal systemic exposure; therefore, it may represent an attractive alternative for antibiotic prophylaxis in certain COPD patients. Inhaled antibiotic prophylaxis has been successfully used in other respiratory conditions such as non-cystic fibrosis bronchiectasis which itself might be present in COPD patients who have chronic bacterial infection, particularly with Pseudomonas aeruginosa.

show abstract

Levofloxacin 500mg once daily versus cefuroxime 250mg twice daily in patients with acute exacerbations of chronic obstructive bronchitis: clinical efficacy and exacerbation-free interval

Cited by 17 publications

References 20 publications

Antibiotic therapy in elderly patients with acute exacerbation of chronic bronchitis

Antibiotic therapy in elderly patients with acute exacerbation of chronic bronchitis

A Review of Levofloxacin for the Treatment of Bacterial Infections

Antibiotics for treatment and prevention of exacerbations of chronic obstructive pulmonary disease

Contact Info

Product

Resources

About