Clinical evaluation of levofloxacin sequential therapy in the treatment of 214 patients with bacterial infections

Objective: To compare the efficacy and safety of intravenous and oral levofloxacin versus ceftriaxone and cefixime in treatment of lower respiratory tract infections(LRTI) and urinary tract infections(UTI). Methods:A prospective, randomized, multicenter, comparative study was carried out in LRTI and UTI patients. Patients received either levofloxacin 300 mg twice daily intravenously followed by the same dosage orally or ceftriaxone 2.0 g once daily intravenously followed by oral cefixime 200 mg three times daily for 10-14 days. Results:Two hundred and fourteen patients were enrolled this study, 192 patients were evaluable, 92 in levofloxacin group with 54 cases of LRTI and 38 UTI; 100 patients in ceftriaxone followed by cefixime group with 59 cases of LRTI and 41 UTI. Clinical cure rates and total effective rates were 77.2%(71/92) and 93.5%(86/92) in levofloxacin group, 82.0%(82/100) and 95.0%(95/100) in control group; the bacterial eradication rates being 93.0%(53/57) and 97.1%(66/68) respectively. The clinical adverse effect rates were 16.0%(17/106) and 4.6%(5/108), while abnormal laboratory tests being 12.3%(13/106) and 13.0%(14/108) in the two groups respectively. No significant difference of the above figures between the two groups were found, however, the adverse effect rates in levofloxacin group was higher than that of control group (P=0.012). Conclusions:Levofloxacin sequential therapy is as effective as parenteral ceftriaxone followed by oral cefixime in the treatment of lower respiratory tract infections and urinary tract infections, adverse effects are mild and transient in both groups but more frequent in levofloxacin group than in control group.