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Shorter Average Length of Stay Observed in Patients Given Levofloxacin for Community-Acquired Pneumonia
The 2007 Infectious Disease Society of America (IDSA) / American Thoracic Society (ATS) Antibiotic Guidelines for the management of CAP with Guideline-Concordant (GC) antibiotics recommends that clinicians choose among concordant regimens for the treatment of CAP in a non-ICU setting with a fluoroquinolone, such as LEVAQUIN, or combination treatment with a beta-lactam plus a macrolide. The interim data supports the use of LEVAQUIN in the treatment of CAP as recommended by the Guidelines.
The interim study results were presented at the 48th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) / Infectious Disease Society of America (IDSA) 46th Annual meeting in Washington, D.C.
"For many years, LEVAQUIN has been an effective treatment option for patients affected by community-acquired pneumonia and a variety of other bacterial infections," said Dr. Christopher Frei, lead author and Assistant Professor, The University of Texas at Austin. "These interim results support the use of LEVAQUIN as a guideline-concordant antibiotic therapy for treatment of hospitalized (non-ICU) patients with CAP."
Data were collected from hospitalized adult patients with a principal CAP diagnosis and positive chest x-ray. Direct ICU admissions and cases contracted in a healthcare setting were excluded. Patients who received antibiotics recommended in the guideline (n=484) were treated with either 750mg daily dose of LEVAQUIN or 1mg of ceftriaxone plus 500mg of azithromycin. Patients with CAP (n= 465) who were treated with an antibiotic therapy that deviated from the guidelines demonstrated greater mortality rates (1.7% vs. .2%), average LOS (6.3 vs. 4.9 days) and average duration of LOIV (5.1 vs. 4.1 days) compared to patients treated with an antibiotic therapy recommended in the guidelines. Baseline differences were noted between these groups and the group who received guideline-recommended therapy were older and had more comorbidities, more corticosteroid use and less pre-admission antibiotic use.
Among all CAP patients who received antibiotic therapy recommended in the IDSA/ATS Guidelines (n=484), those in the LEVAQUIN group (n=309) had statistically significant lower average LOS of 4.6 days versus 5.5 days for those in the ceftriaxone plus azithromycin group (n=175). Additionally, patients in the LEVAQUIN group had a shorter average duration of LOIV of 3.6 days versus 5.0 days for those treated with ceftriaxone plus azithromycin. Baseline differences noted between these groups include higher rates of chronic heart failure and pre-admission antibiotic use in the patients who received ceftriaxone plus azithromycin.
It should be recognized that costs and resource utilization are of importance when considering certain healthcare decisions. These results may be helpful to hospital decision makers who are responsible for selecting drugs as treatment options for CAP in hospitalized patients.
Community-Acquired Pneumonia (CAP)
Community-acquired pneumonia (CAP) is pneumonia acquired in the outpatient or community setting and is a growing health concern, affecting more than 915,000 Americans over age 65 each year. Streptococcus pneumoniae (Pneumococcus) accounts for 16% to 60% of CAP and is the leading cause of the condition. Many patients who present with CAP (58 to 89%) have one or more chronic diseases, including: COPD, cardiovascular disease, neurological disease, diabetes or a history of substance abuse. Pneumonia is also the third most common cause for hospitalization in patients 65 and older and the seventh most frequent cause of death.
LEVAQUIN is indicated for adults with community-acquired pneumonia due to methicillin-susceptible S aureus, S pneumoniae (including multidrug-resistant S pneumoniae [MDRSP]), H influenzae, H parainfluenzae, K pneumoniae, M catarrhalis, C pneumoniae, L pneumophila, or M pneumoniae. MDRSP isolates are strains resistant to two or more of the following antibacterials: penicillin (MIC greater than or equal to 2 micrograms/mL), 2nd generation cephalosporins, eg, cefuroxime, macrolides, tetracyclines, and trimethoprim/sulfamethoxazole. Efficacy of the LEVAQUIN 750 mg/once-daily/5-day regimen has been demonstrated for community-acquired pneumonia caused by S pneumoniae (excluding MDRSP), H influenzae, H parainfluenzae, M pneumoniae, or C pneumoniae.