A Multicenter, Randomized Study Comparing the Efficacy and Safety of Intravenous and/or Oral Levofloxacin versus Ceftriaxone and/or Cefuroxime Axetil in Treatment of Adults with Community-Acquired Pneumonia
Abstract
This study was a prospective, multicenter, randomized trial comparing the efficacy and safety of levofloxacin with that of ceftriaxone and/or cefuroxime in the management of community-acquired pneumonia in adults. The decisions to hospitalize patients, to use an intravenous or oral antimicrobial agent, and to add erythromycin or doxy-cycline to the cephalosporin regimen were made at the investigator's discretion. Four hundred fifty-six patients (226 given levofloxacin and 230 given ceftriaxone and/or cefuroxime axetil) were evaluable for efficacy. Clinical success at 5–7 days posttherapy was 96% in the levofloxacin group and 90% in the cephalosporin group. Microbio-logic success rates were 98% for levofloxacin and 85% for cephalosporin. Both drugs eradicated 100% of Streptococcus pneumoniae. Adverse effects were similar in both groups. The authors conclude that levofloxacin is superior to ceftriaxone and cefuroxime axetil therapy in the management of community-acquired pneumonia in adults.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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