Levofloxacin efficacy in the treatment of community-acquired legionellosis

Chest. 2004 Jun;125(6):2135-9. doi: 10.1378/chest.125.6.2135.

Abstract

Background: Although fluoroquinolones possess excellent in vitro activity against Legionella, few large-scale clinical trials have examined their efficacy in the treatment of Legionnaires disease. Even fewer studies have applied rigorous criteria for diagnosis of community-acquired Legionnaires disease, including culture of respiratory secretions on selective media.

Methods: Data from six clinical trials encompassing 1,997 total patients have been analyzed to determine the efficacy of levofloxacin (500 mg qd or 750 mg qd) in treating patients with community-acquired pneumonia (CAP) due to Legionella.

Results: Of the 1,997 total patients with CAP from the clinical trials, 75 patients had infection with a Legionella species. Demographics showed a large portion of these patients were < 55 years of age and nonsmokers. More than 90% of mild-to-moderate and severe cases of Legionella infection resolved clinically at the posttherapy visit, 2 to 14 days after treatment termination. No deaths were reported for any patient with Legionnaires disease treated with levofloxacin during the studies.

Conclusions: Levofloxacin was efficacious at both 500 mg for 7 to 14 days and 750 mg for 5 days. Legionnaires disease is not associated only with smokers, the elderly, and the immunosuppressed, but also has the potential to affect a broader demographic range of the general population than previously thought.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Trials as Topic
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Legionella pneumophila / drug effects*
  • Legionella pneumophila / isolation & purification
  • Legionnaires' Disease / diagnosis
  • Legionnaires' Disease / drug therapy*
  • Levofloxacin*
  • Male
  • Ofloxacin / administration & dosage*
  • Risk Assessment
  • Treatment Outcome

Substances

  • Levofloxacin
  • Ofloxacin