Levofloxacin (Page 13 of 16)
14.7 Complicated Urinary Tract Infections and Acute Pyelonephritis: 5-day Treatment Regimen
To evaluate the safety and efficacy of the higher dose and shorter course of levofloxacin, 1109 patients with cUTI and AP were enrolled in a randomized, double-blind, multicenter clinical trial conducted in the US from November 2004 to April 2006 comparing levofloxacin 750 mg IV or orally once daily for 5 days (546 patients) with ciprofloxacin 400 mg IV or 500 mg orally twice daily for 10 days (563 patients). Patients with AP complicated by underlying renal diseases or conditions such as complete obstruction, surgery, transplantation, concurrent infection or congenital malformation were excluded. Efficacy was measured by bacteriologic eradication of the baseline organism(s) at the post-therapy visit in patients with a pathogen identified at baseline. The post-therapy (test-of-cure) visit occurred 10 to 14 days after the last active dose of levofloxacin and 5 to 9 days after the last dose of active ciprofloxacin.
The bacteriologic cure rates overall for levofloxacin and control at the test-of-cure (TOC) visit for the group of all patients with a documented pathogen at baseline (modified intent to treat or mITT) and the group of patients in the mITT population who closely followed the protocol (Microbiologically Evaluable) are summarized in Table 16.
| |||||
Levofloxacin 750 mg orally or IV once dailyfor 5 days | Ciprofloxacin 400 mg IV/500 mg orally twice dailyfor 10 days | Overall Difference[95% Cl] | |||
n/N | % | n/N | % | Levofloxacin — Ciprofloxacin | |
mITT Population * | |||||
Overall (cUTI or AP) | 252/333 | 75.7 | 239/318 | 75.2 | 0.5 [-6.1, 7.1] |
cUTI | 168/230 | 73.0 | 157/213 | 73.7 | |
AP | 84/103 | 81.6 | 82/105 | 78.1 | |
Microbiological Evaluable Population † | |||||
Overall (cUTI or AP) | 228/265 | 86.0 | 215/241 | 89.2 | -3.2 [-8.9, 2.5] |
cUTI | 154/185 | 83.2 | 144/165 | 87.3 | |
AP | 74/80 | 92.5 | 71/76 | 93.4 |
Microbiologic eradication rates in the Microbiologically Evaluable population at TOC for individual pathogens recovered from patients randomized to levofloxacin treatment are presented in Table 17.
| ||
Pathogen | Bacteriological Eradication Rate(n/N) | % |
Escherichia coli * | 155/172 | 90 |
Klebsiella pneumoniae | 20/23 | 87 |
Proteus mirabilis | 12/12 | 100 |
14.8 Complicated Urinary Tract Infections and Acute Pyelonephritis: 10-day Treatment Regimen
To evaluate the safety and efficacy of the 250 mg dose, 10 day regimen of levofloxacin, 567 patients with uncomplicated UTI, mild-to-moderate cUTI, and mild-to-moderate AP were enrolled in a randomized, double-blind, multicenter clinical trial conducted in the US from June 1993 to January 1995 comparing levofloxacin 250 mg orally once daily for 10 days (285 patients) with ciprofloxacin 500 mg orally twice daily for 10 days (282 patients). Patients with a resistant pathogen, recurrent UTI, women over age 55 years, and with an indwelling catheter were initially excluded, prior to protocol amendment which took place after 30% of enrollment. Microbiological efficacy was measured by bacteriologic eradication of the baseline organism(s) at 1–12 days post-therapy in patients with a pathogen identified at baseline.
The bacteriologic cure rates overall for levofloxacin and control at the test-of-cure (TOC) visit for the group of all patients with a documented pathogen at baseline (modified intent to treat or mITT) and the group of patients in the mITT population who closely followed the protocol (Microbiologically Evaluable) are summarized in Table 18.
| ||||
Levofloxacin 250 mg once daily for 10 days | Ciprofloxacin 500 mg twice daily for 10 days | |||
n/N | % | n/N | % | |
mITT Population † | 174/209 | 83.3 | 184/219 | 84.0 |
Microbiologically Evaluable Population ‡ | 164/177 | 92.7 | 159/171 | 93.0 |
All MedLibrary.org resources are included in as near-original form as possible, meaning that the information from the original provider has been rendered here with only typographical or stylistic modifications and not with any substantive alterations of content, meaning or intent.