Short-course levofloxacin a success in acute pyelonephritis

Levofloxacin [Levaquin] 750mg once daily for 5 days is noninferior to ciprofloxacin [Ciproxin] twice daily for 10 days in the treatment of patients with acute pyelonephritis, according to results of a study presented at the 17th European Congress of Clinical Microbiology and Infectious Diseases and the 25th International Congress of Chemotherapy (ECCMID - ICC) [Munich, Germany; March-April, 2007]. The current study, which represents one of the largest cohorts of acute pyelonephritis patients to date, demonstrated that the 5−dose regimen of levofloxacin was associated with similar microbiological and clinical outcomes to 20 doses of ciprofloxacin at end of therapy (day 10) and post-therapy (day 15−19). The microbiological eradication rates post-therapy (primary endpoint) were 83.0% and 79.6% in the levofloxacin and ciprofloxacin treatment groups, respectively. Patients with complicated acute pyelonephritis demonstrated a higher incidence of bacteraemia, and lower rates of clinical response and microbiological eradication, compared with patients who had uncomplicated acute pyelonephritis. Among patients with bacteraemia at baseline, 25% met the criteria for complicated acute pyelonephritis; in patients who had a repeat blood culture, the blood pathogen eradication rate was 100% in both treatment groups post-therapy.