JAC Advance Access published online on December 12, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg035
© 2002 by The British Society for Antimicrobial Chemotherapy
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Original Paper
1 Institute of Clinical
Pharmacology and Toxicology, Department of Experimental and Clinical
Pathology
and Medicine, Medical School, University of Udine, P.le S. Maria
della Misericordia 3, 33100 Udine
* Corresponding author. E-mail: federico.pea{at}med.uniud.it.
Received 2 August 2002
; revised 10 September 2002
; accepted 3 October 2002
Levofloxacin is considered an effective antibiotic
in the treatment of community-acquired lower respiratory tract infections
(LRTIs). A study was carried out on 17 in-patients to assess the pharmacokinetics
of a 500 mg once-daily switch intravenous (iv)/oral regimen of levofloxacin
in the treatment of LRTI patients. Blood samples were collected
under steady-state conditions at appropriate intervals. Levofloxacin
plasma concentrations were analysed by means of HPLC and pharmacokinetic
parameters were estimated using the WinNonlin pharmacokinetic software
package. A lower clearance of levofloxacin (<2 mL/min/kg),
conditioning both a longer elimination half-life (
Keywords: levofloxacin, oral bioavailability, switch therapy,
elderly
Pharmacokinetic aspects of levofloxacin 500 mg
once daily during sequential intravenous/oral therapy in patients
with lower respiratory tract infections
2 Division of Pneumology, S. Maria
della Misericordia Hospital, Udine, Italy
9
h) and a larger AUC0-
(80 mg/L·h), was observed for
both routes in our patients than in healthy volunteers.
These differences may be explained considering that levofloxacin
is excreted mainly as unchanged drug by the renal route, and most
of our patients (71%) were very elderly subjects whose
renal function physiologically declines with age. The almost complete
(
99%) absolute oral bioavailability
suggests that a comparable exposure to the iv regimen may be achieved
after oral administration. The overall clinical success rate was 94.1%.
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