P-1331. Efficacy of Levofloxacin for Levofloxacin-Susceptible, Ciprofloxacin-Nonsusceptible Enterobacterales
Abstract
Abstract Background Fluoroquinolones (FQ) are critical Gram-negative agents due to their oral availability and stability against beta-lactamases such as ESBL and AmpC. Resistant organisms frequently co-harbor FQ resistance genes. There are copious resistance mechanisms and no widely available genotypic analysis, yet in vitro studies suggest a higher resistance risk for discordant susceptibilities. Discordance is documented in a subset of Enterobacterales isolates; there is a paucity of literature describing FQ efficacy in this population. We aim to evaluate microbiologic and clinical success of patients receiving levofloxacin LVX-Susceptible (LVX-S), Ciprofloxacin-nonsusceptible (CIP-NS) Enterobacterales.Table 1. Published Microbiologic Success in Similar Populations Methods This is a single-arm, retrospective, descriptive analysis of patients aged 18-89 treated for LVX-S, CIP-NS Enterobacterales who received LVX. Susceptibility testing was performed via Phoenix BMD with the exception of Serratia (Kirby Bauer). Primary outcome was 90d microbiologic failure, defined as growth of the same organism within 90d of index culture. Secondary outcomes were growth of LVX-R isolates, 90d treatment failure defined as retreatment regardless of cultures, receipt of salvage therapy, and 90d all-cause mortality. Results Preliminary reporting identified 73 patients; 48 were included. Median age was 60.0 and patients were predominantly female (66.7%). Most common organism was K. pneumoniae…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 73 participants or records.
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