López-Véjar CE, Castellanos-De la Cruz L, Meraz-Ortega R, Román- Flores A, Geuguer-Chávez L, Pedro-González A, Lozano-Nuevo JJ, Rubio- Guerra A

Language: Spanish
References: 19
Page: 587-594
PDF size: 554.91 Kb.

ABSTRACT

Background: Almost all guidelines and recommendations for the treatment of pneumonia acquired in the community requiring hospitalization indicate as first line of treatment cephalosporins of third-generation and a macrolide, and emphasize that local antimicrobial resistance must be considered since fluoroquinolone such as levofloxacin or moxifloxacin can play an important role.
Objective: To determine whether levofloxacin is as effective as conventional therapy with ceftriaxone plus clarithromycin for the management of the community-acquired pneumonia in hospital centers of Health Ministry of Mexico.
Materials and method: An open-label randomized and controlled trial was performed in two hospitals of Mexico City. Sample size was calculated for a significance alpha ‹ 0.05, comparing the response to two antibiotic regimens in the treatment of community-acquired pneumonia requiring hospitalization [group 1 (n=36), ceftriaxone plus clartithromycin, and group 2 (n=36) levofloxacin. Secondary objectives were to determine hospital mortality and the relationship of risk factor for treatment failure.
Results: Statistical analysis did not show a statistically significant response (p ‹ 0.114) for healing between the two treatment groups. There was not significant difference in mortality. It was determined as a risk factor for the lack of response to antibiotics having any sequel of neurological disease, and for the lack of response to levofloxacin, chronic alcoholism.
Conclusions: Levofloxacin is as effective as ceftriaxone plus clarithromycin as initial antibiotic therapy in the management of community-acquired pneumonia.

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