TY - JOUR
T1 - Levofloxacin for treatment of ventilator-associated pneumonia
T2 - A subgroup analysis from a randomized trial
AU - Shorr, Andrew F.
AU - Zadeikis, Neringa
AU - Jackson, William L.
AU - Ramage, Anthony S.
AU - Wu, Shu Chen
AU - Tennenberg, Alan M.
AU - Kollef, Marin H.
N1 - Funding Information:
Potential conflicts of interest. N.Z., S.-C.W., and A.M.T. were employees of Ortho-McNeil Pharmaceutical at the time the present study was conducted, but no extramural funding was provided for the preparation of this analysis. A.F.S. and M.H.K. have received research support from Ortho-McNeil Pharmaceutical, but no extra funding was provided for the preparation of this analysis. W.L.J. and A.S.R.: no conflicts.
PY - 2005/2/24
Y1 - 2005/2/24
N2 - Ventilator-associated pneumonia (VAP) remains a significant challenge in critical care. We conducted a secondary analysis of a multicenter, prospective, randomized trial comparing levofloxacin (750 mg iv q24h) with imipenem-cilastatin (500-1000 mg iv q6-8h) for treatment of nosocomial pneumonia and focused on the subgroup of patients with VAP. The study cohort included 222 patients, with half (111) of the patients assigned to each treatment group. The patients in both groups were similar with respect to age, severity of illness, and duration of mechanical ventilation before the onset of VAP. Among the intention-to-treat population, clinical success was achieved in 58.6% of patients receiving levofloxacin, compared with 63.1% of patients receiving imipenem-cilastatin (P = .49; 95% confidence interval for the difference, -8.77% to 17.79%). Microbiological success and 28-day mortality rates were also comparable. Multivariate analysis demonstrated that assignment to antibiotic treatment (i.e., levofloxacin vs. imipenem-cilastatin) was not predictive of outcomes, thus suggesting that the treatment regimens were equivalent. Both levofloxacin and imipenem-cilastatin regimens were well tolerated and had similar adverse event profiles.
AB - Ventilator-associated pneumonia (VAP) remains a significant challenge in critical care. We conducted a secondary analysis of a multicenter, prospective, randomized trial comparing levofloxacin (750 mg iv q24h) with imipenem-cilastatin (500-1000 mg iv q6-8h) for treatment of nosocomial pneumonia and focused on the subgroup of patients with VAP. The study cohort included 222 patients, with half (111) of the patients assigned to each treatment group. The patients in both groups were similar with respect to age, severity of illness, and duration of mechanical ventilation before the onset of VAP. Among the intention-to-treat population, clinical success was achieved in 58.6% of patients receiving levofloxacin, compared with 63.1% of patients receiving imipenem-cilastatin (P = .49; 95% confidence interval for the difference, -8.77% to 17.79%). Microbiological success and 28-day mortality rates were also comparable. Multivariate analysis demonstrated that assignment to antibiotic treatment (i.e., levofloxacin vs. imipenem-cilastatin) was not predictive of outcomes, thus suggesting that the treatment regimens were equivalent. Both levofloxacin and imipenem-cilastatin regimens were well tolerated and had similar adverse event profiles.
UR - http://www.scopus.com/inward/record.url?scp=13944264298&partnerID=8YFLogxK
U2 - 10.1086/426192
DO - 10.1086/426192
M3 - Article
C2 - 15712100
AN - SCOPUS:13944264298
SN - 1058-4838
VL - 40
SP - S123-S129
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - SUPPL.
ER -