A randomized controlled multicentre clinical trial of levofloxacin sequential therapy compared with combination therapy with cefuroxime and azithromycin in patients with community-acquired pneumonia

Objective To evaluate the clinical consequences and cost-effectiveness of levofloxacin sequential therapy(intravenous infusion followed by oral administration) in patients with community-acquired pneumonia.Methods Combination therapy with cefuroxime and azithromycin was used as control regimen.A randomized controlled multicentre clinical trial was conducted to evaluate the efficacy,safety and cost-effectiveness of levofloxacin in patients with community-acquired pneumonia.Results Of the total 378 cases with community-acquired pneumonia,190 were treated with sequential levofloxacin,188 were treated with cefuroxime plus azithromycin.In the levofloxacin treatment group,the cure and efficacy rate were 67.37% and 96.84% respectively.The bacterial eradication rate was 96.77%.The incidence of adverse drug reaction was 10.53%.In cefuroxime and azithromycin combination group,the cure and efficacy rate were 64.36% and 96.28% respectively.The bacterial eradication rate was 96.67%.The incidence of adverse drug reaction was 7.98%.There was no significant difference between the two groups in terms of these parameters.The mean duration of treatment,days of hospital stay,and cost of hospitalization did not show significant difference between the two groups.However,levofloxacin sequential therapy(cost of 32.01) was more cost-effective than cefuroxime plus azithromycin(cost of 38.51).The difference was statistically significant.Conclusions Levofloxacin sequential therapy is efficacious,safe and cost-effective in treatment of community-acquired pneumonia.