Cumulative Clinical Trial Experience with Levofloxacin for Patients with Community-Acquired Pneumonia-Associated Pneumococcal Bacteremia

Abstract

Streptococcus pneumoniae has been isolated in up to two-thirds of all cases of community-acquired pneumonia (CAP), and pneumococcal bacteremia has been associated in 20%-25% of these cases. The recent literature has suggested that better outcomes are achieved with the use of combination therapy for the treatment of pneumococcal bacteremia. The present study analyzed the efficacy of levofloxacin monotherapy in the treatment of patients with a diagnosis of pneumococcal bacteremia who participated in clinical trials for the treatment of CAP. A total of 108 patients from 9 clinical trials were identified as having pneumococcal bacteremia, including 12 patients infected with penicillin- or macrolide-resistant strains. Overall, 98 (90.7%) of 108 microbiologically evaluable patients had a successful clinical response, including 11 (91.7%) of 12 patients infected with a macrolide- or penicillin-resistant strain. The mortality rate in this population was <1%. The present study suggests that levofloxacin monotherapy can be an effective choice for the treatment of CAP-associated pneumococcal bacteremia.