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Submitted: 16 May 2007 Modified: 04 March 2019
HERDIN Record #: PCHRDPC011204

A randomized controlled trial comparing the effectiveness and safety of once daily levofloxacin versus ceftriaxone with or without erythromycin in the treatment of community-acquired pneumonia.

Ma. Bella Siasoco ,
Josefino Bobadilla,
Joselito Chavez ,
Suzette Lazo ,
Noel Espallardo

OBJECTIVE: This study was conducted to determine the effectiveness of oral levofloxacin alone compared with intravenous ceftriaxone with or without erythromycin for the treatment of community-acquired pneumonia Setting: The study was conducted at the Philippine General Hospital, a tertiary-care government hospital affiliated with the College of Medicine of the University of the Philippines


METHODOLOGY: Randomized, controlled, open-labelled trial. Patients who were admitted for the treatment of community-acquired pneumonia were randomized into two groups. One group received levofloxacin 500 mg tablet once daily for 7 days while the other group received ceftriaxone 2 grams intravenously with or without erythromycin 500 mg capsule three times daily for 7 days. Patients were observed for 7 to 14 days for clinical symptoms and adverse events. Intention-to-treat analysis for cure rate and adverse events and survival analysis were done.


RESULTS: Seventy consecutive patients, ages 18 to 65 years old., [who were] admitted for the treatment of community-acquired pneumonia were included in the study. Thirty-six patients were randomized to the levofloxacin group while 34 randomized into the ceftriaxone group. There were no statistically significant differences in terms of sociodemographic and clinical profiles of patients between the two treatment groups. After two weeks of follow-up, the patients on levofloxacin had a higher cure rate than the ceftriaxone group (94.28% in levofloxacin s. 67.65 in the ceftriaxone group); [and] the difference was statistically significant (Mann-Whitney U test p-value = 0.01). The mean time to cure in the levofloxacin group was also shorter (8.67 +/- 0.60 days) than the ceftriaxone group (9.94 +/- 0.68 days). Survial cure analysis (Kaplan-Mier) of time to cure was noted to be better in the levofloxacin group was statistically significant (Log rank p value = 0.03). Three patients died of cardiovascular causes while enrolled in the study (2 in the ceftriaxone group, 1 in the levofloxacin group). Tolerable adverse events (nausea) were noted in 2 patients receiving levofloxacin.


CONCLUSION: The study showed that oral levofloxacin is safer and more effective than intavenous ceftriaxone with or without erythromycin in the treatment of community acquired pneumonia.

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Internal Medicine
Frequency
Others
Publication Date
January-February 2000
Volume
38
Issue
1
Page(s)
26-31
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 48 Fulltext Print Format (Request Document)
Philippine Council for Health Research and Development Fulltext pdf (Request Document)

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