High-dose, short-course Levofloxacin for community-acquired pneumonia: A new treatment paradigm
High-dose, short-course Levofloxacin for community-acquired pneumonia: A new treatment paradigm
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DOI：
10.1086/377539
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发表时间：
2003-09-15
影响因子：
11.8
通讯作者：
Kahn, JB
中科院分区：
文献类型：
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作者：
Dunbar, LM;Wunderink, RG;Kahn, JB
左氧氟沙星显示出浓度依赖性杀菌活性，其与浓度-时间曲线下面积（AUC）与最小抑菌浓度（MIC）的比值以及血浆峰浓度（C-max）与MIC的比值等药效学参数最密切相关。将左氧氟沙星的剂量增加到750 mg，通过增加药物峰浓度来利用这些参数，从而缩短治疗过程而不减少治疗益处。一项多中心、随机、双盲研究证实了这一点，该研究比较了左氧氟沙星750 mg/天持续5天与500 mg/天持续10天治疗轻度至重度社区获得性肺炎（CAP）的效果。在临床可评价人群中，750 mg组的临床成功率为92.4%（183/198人），500 mg组为91.1%（175/192人）（95%置信区间，-7.0至4.4）。750 mg和500 mg组的微生物根除率分别为93.2%和92.4%。这些数据表明，对于治疗轻度至重度CAP，每天750 mg左氧氟沙星持续5天至少与每天500 mg左氧氟沙星持续10天一样有效。
Levofloxacin demonstrates concentration-dependent bactericidal activity most closely related to the pharmacodynamic parameters of the ratio of area under the concentration-time curve (AUC) to minimum inhibitory concentration (MIC) and the ratio of peak plasma concentration (C-max) to MIC. Increasing the dose of levofloxacin to 750 mg exploits these parameters by increasing peak drug concentrations, allowing for a shorter course of treatment without diminishing therapeutic benefit. This was demonstrated in a multicenter, randomized, double-blind investigation that compared levofloxacin dosages of 750 mg per day for 5 days with 500 mg per day for 10 days for the treatment of mild to severe community-acquired pneumonia ( CAP). In the clinically evaluable population, the clinical success rates were 92.4% ( 183 of 198 persons) for the 750-mg group and 91.1% ( 175 of 192 persons) for the 500-mg group (95% confidence interval, - 7.0 to 4.4). Microbiologic eradication rates were 93.2% and 92.4% in the 750-mg and 500-mg groups, respectively. These data demonstrate that 750 mg of levofloxacin per day for 5 days is at least as effective as 500 mg per day for 10 days for treatment of mild-to-severe CAP.