Pneumonia due to Pseudomonas aeruginosa:the levofloxacin clinical trials experience
ABSTRACT Respiratory infections caused by Pseudomonas aeruginosa present significant treatment challenges, including that of overcoming intrinsic and adaptive resistance by these organisms. The fluoroquinolones may provide an effective option for treating these infections. In this analysis, we repor...
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Veröffentlicht in: | Current medical research and opinion 2006-05, Vol.22 (5), p.843-850 |
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description | ABSTRACT
Respiratory infections caused by Pseudomonas aeruginosa present significant treatment challenges, including that of overcoming intrinsic and adaptive resistance by these organisms. The fluoroquinolones may provide an effective option for treating these infections. In this analysis, we report on the efficacy of levofloxacin in the treatment of community-acquired pneumonia (CAP) and nosocomial pneumonia caused by P. aeruginosa using information from nine clinical studies supported by Johnson & Johnson Pharmaceutical Research and Development (Raritan, NJ) or Ortho-McNeil Pharmaceutical (Raritan, NJ). From these studies, a total of 36 patients were identified with pneumonia caused by P. aeruginosa and treated with levofloxacin (750 mg or 500 mg). For patients diagnosed with nosocomial pneumonia, levofloxacin treatment achieved a 64.7% (11/17) clinical success rate, compared with 41.2% (7/17) with comparator treatment (imipenem/cilastatin followed by ciprofloxacin) in the microbiologically evaluable population. Eradication rates were 58.8% with levofloxacin treatment vs. 29.4% with comparator (95% CI, -64.2 to 5.4). For levofloxacin-treated CAP patients with P. aeruginosa infections (n = 19), clinical success and microbiological eradication rates in the microbiologically evaluable population were 89.5% and 78.9%, respectively. Several limitations of this analysis exist including that this was a retrospective evaluation that pooled data from multiple studies with varying protocols, the number of patients included was limited, and the nosocomial pneumonia patients used adjunctive therapy with an antipseudomonal β-lactam in most cases. Nonetheless, these findings suggest that levofloxacin may play a role in the treatment of these difficult respiratory infections. |
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Respiratory infections caused by Pseudomonas aeruginosa present significant treatment challenges, including that of overcoming intrinsic and adaptive resistance by these organisms. The fluoroquinolones may provide an effective option for treating these infections. In this analysis, we report on the efficacy of levofloxacin in the treatment of community-acquired pneumonia (CAP) and nosocomial pneumonia caused by P. aeruginosa using information from nine clinical studies supported by Johnson & Johnson Pharmaceutical Research and Development (Raritan, NJ) or Ortho-McNeil Pharmaceutical (Raritan, NJ). From these studies, a total of 36 patients were identified with pneumonia caused by P. aeruginosa and treated with levofloxacin (750 mg or 500 mg). For patients diagnosed with nosocomial pneumonia, levofloxacin treatment achieved a 64.7% (11/17) clinical success rate, compared with 41.2% (7/17) with comparator treatment (imipenem/cilastatin followed by ciprofloxacin) in the microbiologically evaluable population. Eradication rates were 58.8% with levofloxacin treatment vs. 29.4% with comparator (95% CI, -64.2 to 5.4). For levofloxacin-treated CAP patients with P. aeruginosa infections (n = 19), clinical success and microbiological eradication rates in the microbiologically evaluable population were 89.5% and 78.9%, respectively. Several limitations of this analysis exist including that this was a retrospective evaluation that pooled data from multiple studies with varying protocols, the number of patients included was limited, and the nosocomial pneumonia patients used adjunctive therapy with an antipseudomonal β-lactam in most cases. Nonetheless, these findings suggest that levofloxacin may play a role in the treatment of these difficult respiratory infections.</description><identifier>ISSN: 0300-7995</identifier><identifier>EISSN: 1473-4877</identifier><identifier>DOI: 10.1185/030079906X100195</identifier><identifier>PMID: 16709306</identifier><identifier>CODEN: CMROCX</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Adult ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Ciprofloxacin - pharmacology ; Ciprofloxacin - therapeutic use ; Clinical efficacy ; Community-Acquired Infections - drug therapy ; Community-Acquired Infections - microbiology ; Community-acquired pneumonia ; Cross Infection - drug therapy ; Cross Infection - microbiology ; Drug Resistance, Microbial ; Humans ; Levofloxacin ; Nosocomial pneumonia ; Ofloxacin - pharmacology ; Ofloxacin - therapeutic use ; Pneumonia, Bacterial - drug therapy ; Pneumonia, Bacterial - microbiology ; Pseudomonas aeruginosa ; Pseudomonas aeruginosa - drug effects ; Pseudomonas aeruginosa - isolation & purification ; Pseudomonas Infections - complications ; Risk Assessment ; Risk Factors ; Treatment Outcome</subject><ispartof>Current medical research and opinion, 2006-05, Vol.22 (5), p.843-850</ispartof><rights>2006 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2006</rights><rights>Copyright Librapharm May 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c427t-abe0cad035622cecda800116c9266114e526d9488421e52cb1b28f7e09a21f333</citedby><cites>FETCH-LOGICAL-c427t-abe0cad035622cecda800116c9266114e526d9488421e52cb1b28f7e09a21f333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1185/030079906X100195$$EPDF$$P50$$Ginformaworld$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1185/030079906X100195$$EHTML$$P50$$Ginformaworld$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,59647,59753,60436,60542,61221,61256,61402,61437</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16709306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tennenberg, Alan M.</creatorcontrib><creatorcontrib>Davis, Neelam B.</creatorcontrib><creatorcontrib>Wu, Shu-Chen</creatorcontrib><creatorcontrib>Kahn, James</creatorcontrib><title>Pneumonia due to Pseudomonas aeruginosa:the levofloxacin clinical trials experience</title><title>Current medical research and opinion</title><addtitle>Curr Med Res Opin</addtitle><description>ABSTRACT
Respiratory infections caused by Pseudomonas aeruginosa present significant treatment challenges, including that of overcoming intrinsic and adaptive resistance by these organisms. The fluoroquinolones may provide an effective option for treating these infections. In this analysis, we report on the efficacy of levofloxacin in the treatment of community-acquired pneumonia (CAP) and nosocomial pneumonia caused by P. aeruginosa using information from nine clinical studies supported by Johnson & Johnson Pharmaceutical Research and Development (Raritan, NJ) or Ortho-McNeil Pharmaceutical (Raritan, NJ). From these studies, a total of 36 patients were identified with pneumonia caused by P. aeruginosa and treated with levofloxacin (750 mg or 500 mg). For patients diagnosed with nosocomial pneumonia, levofloxacin treatment achieved a 64.7% (11/17) clinical success rate, compared with 41.2% (7/17) with comparator treatment (imipenem/cilastatin followed by ciprofloxacin) in the microbiologically evaluable population. Eradication rates were 58.8% with levofloxacin treatment vs. 29.4% with comparator (95% CI, -64.2 to 5.4). For levofloxacin-treated CAP patients with P. aeruginosa infections (n = 19), clinical success and microbiological eradication rates in the microbiologically evaluable population were 89.5% and 78.9%, respectively. Several limitations of this analysis exist including that this was a retrospective evaluation that pooled data from multiple studies with varying protocols, the number of patients included was limited, and the nosocomial pneumonia patients used adjunctive therapy with an antipseudomonal β-lactam in most cases. Nonetheless, these findings suggest that levofloxacin may play a role in the treatment of these difficult respiratory infections.</description><subject>Adult</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Ciprofloxacin - pharmacology</subject><subject>Ciprofloxacin - therapeutic use</subject><subject>Clinical efficacy</subject><subject>Community-Acquired Infections - drug therapy</subject><subject>Community-Acquired Infections - microbiology</subject><subject>Community-acquired pneumonia</subject><subject>Cross Infection - drug therapy</subject><subject>Cross Infection - microbiology</subject><subject>Drug Resistance, Microbial</subject><subject>Humans</subject><subject>Levofloxacin</subject><subject>Nosocomial pneumonia</subject><subject>Ofloxacin - pharmacology</subject><subject>Ofloxacin - therapeutic use</subject><subject>Pneumonia, Bacterial - drug therapy</subject><subject>Pneumonia, Bacterial - microbiology</subject><subject>Pseudomonas aeruginosa</subject><subject>Pseudomonas aeruginosa - drug effects</subject><subject>Pseudomonas aeruginosa - isolation & purification</subject><subject>Pseudomonas Infections - complications</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>0300-7995</issn><issn>1473-4877</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kM1rGzEQxUVpaJy0957K0kNvm0jaXe0qOQWTj0IghqTQmxhrZ2sZreRIu43z30fGBlNDc5KY-b2ZN4-Qr4yeMdZU57SgtJaSit-MUiarD2TCyrrIy6auP5LJpp2nfnVMTmJcJoQ3Un4ix0zUVBZUTMjjzOHYe2cga0fMBp_NIo6tTyWIGWAY_xjnI1wMC8ws_vWd9WvQxmXaGmc02GwIBmzMcL3CYNBp_EyOulTBL7v3lPy6uX6a3uX3D7c_p1f3uS55PeQwR6qhpUUlONeoW2iSQya05EIwVmLFRSvLpik5S389Z3PedDVSCZx1RVGckh_buavgn0eMg-pN1GgtOPRjVCKdni4uE_j9AFz6MbjkTXGalnJZbiC6hXTwMQbs1CqYHsKrYlRt0laHaSfJt93ccd5juxfs4k3A5RYwrvOhhxcfbKsGeLU-dAGcNlEV74y_-Ee9QLDDQkPAvf__it8A64yfQg</recordid><startdate>200605</startdate><enddate>200605</enddate><creator>Tennenberg, Alan M.</creator><creator>Davis, Neelam B.</creator><creator>Wu, Shu-Chen</creator><creator>Kahn, James</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Informa Healthcare</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>200605</creationdate><title>Pneumonia due to Pseudomonas aeruginosa:the levofloxacin clinical trials experience</title><author>Tennenberg, Alan M. ; 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Respiratory infections caused by Pseudomonas aeruginosa present significant treatment challenges, including that of overcoming intrinsic and adaptive resistance by these organisms. The fluoroquinolones may provide an effective option for treating these infections. In this analysis, we report on the efficacy of levofloxacin in the treatment of community-acquired pneumonia (CAP) and nosocomial pneumonia caused by P. aeruginosa using information from nine clinical studies supported by Johnson & Johnson Pharmaceutical Research and Development (Raritan, NJ) or Ortho-McNeil Pharmaceutical (Raritan, NJ). From these studies, a total of 36 patients were identified with pneumonia caused by P. aeruginosa and treated with levofloxacin (750 mg or 500 mg). For patients diagnosed with nosocomial pneumonia, levofloxacin treatment achieved a 64.7% (11/17) clinical success rate, compared with 41.2% (7/17) with comparator treatment (imipenem/cilastatin followed by ciprofloxacin) in the microbiologically evaluable population. Eradication rates were 58.8% with levofloxacin treatment vs. 29.4% with comparator (95% CI, -64.2 to 5.4). For levofloxacin-treated CAP patients with P. aeruginosa infections (n = 19), clinical success and microbiological eradication rates in the microbiologically evaluable population were 89.5% and 78.9%, respectively. Several limitations of this analysis exist including that this was a retrospective evaluation that pooled data from multiple studies with varying protocols, the number of patients included was limited, and the nosocomial pneumonia patients used adjunctive therapy with an antipseudomonal β-lactam in most cases. Nonetheless, these findings suggest that levofloxacin may play a role in the treatment of these difficult respiratory infections.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>16709306</pmid><doi>10.1185/030079906X100195</doi><tpages>8</tpages></addata></record> |
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subjects | Adult Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Ciprofloxacin - pharmacology Ciprofloxacin - therapeutic use Clinical efficacy Community-Acquired Infections - drug therapy Community-Acquired Infections - microbiology Community-acquired pneumonia Cross Infection - drug therapy Cross Infection - microbiology Drug Resistance, Microbial Humans Levofloxacin Nosocomial pneumonia Ofloxacin - pharmacology Ofloxacin - therapeutic use Pneumonia, Bacterial - drug therapy Pneumonia, Bacterial - microbiology Pseudomonas aeruginosa Pseudomonas aeruginosa - drug effects Pseudomonas aeruginosa - isolation & purification Pseudomonas Infections - complications Risk Assessment Risk Factors Treatment Outcome |
title | Pneumonia due to Pseudomonas aeruginosa:the levofloxacin clinical trials experience |
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