Vol.55 No.6 November 2007

Comparison of 5 day short-course therapies for secondary infection in patients with chronic respiratory disease using gatifloxacin and levofloxacin

Morio Nakamura¹⁾, Naoki Hasegawa²⁾, Naoki Miyao³⁾, Takahiro Nakajima⁴⁾, Takeshi Terashima⁵⁾, Fumio Sakamaki⁶⁾, Rika Hiraoka⁷⁾, Hiroaki Matsubara⁸⁾, Yoshitaka Oyamada⁹⁾, Makoto Yonemaru¹⁰⁾, Kazumi Nishio¹¹⁾, Naoto Shimada¹¹⁾, Ichiro Kawada¹²⁾, Katsuhiko Naoki¹³⁾, Sadatomo Tasaka²⁾, Tomoyasu Nishimura²⁾ and Akitoshi Ishizaka²⁾

¹⁾Eiju General Hospital, 2-23-16 Higashi-Ueno, Taito-ku, Tokyo, Japan
²⁾Division of Pulmonary Medicine, Keio University School of Medicine
³⁾Nippon Kokan Hospital
⁴⁾Kawasaki Municipal Kawasaki Hospital
⁵⁾Tokyo Dental College Ichikawa General Hospital
⁶⁾Saiseikai Central Hospital
⁷⁾Saitama Municipal Hospital
⁸⁾Fussa Hospital
⁹⁾National Hospital Organization Tokyo Medical Center
¹⁰⁾Isehara Kyodo Hospital
¹¹⁾Kawasaki Municipal Ida Hospital
¹²⁾Hino Municipal Hospital
¹³⁾Yokohama Municipal Citizen's Hospital

Abstract

[Objective] This study was conducted in patients of secondary infection with chronic respiratory disease in order to compare 5 day short-course therapies employing gatifloxacin(GFLX) and levofloxacin(LVFX). In addition to the shortening of treatment periods, we also investigated the economic efficiency of this medical treatment.
[Materials and methods] A total of 74 patients with secondary infection in chronic respiratory disease were enrolled and treated with the study drugs. The study was conducted between September, 2006 and April, 2007 at Keio University Hospital and its affiliated hospitals and clinics. This was a randomized study in which patients were randomly assigned to one of the following two treatment groups: GFLX group (200 mg twice daily for patients aged ≥65 years and 400 mg twice daily in patients aged <65 years), LVFX group (400 mg twice daily). The duration of antibiotic therapy was 5 days.
[Results] 61 patients (GFLX group: 32, LVFX group: 29) were evaluated for the efficacy of the medications, 74 patients (GFLX group: 37, LVFX group: 37) were evaluated for side effects, and 63 patients (GFLX group: 30, LVFX group: 33) were evaluated for abnormal laboratory results from a total of 74 patients. Clinical efficacy was 90.6% (29/32) in the GFLX group and 89.7% (26/29) in the LVFX group. Side effects were observed in 2 cases in the GFLX group, and 2 abnormal laboratory results were observed (1 in the GFLX group and 1 in the LVFX group). These cases were all mild in nature.
[Conclusion] Conventional management recommends 7-14 days of antibiotic therapy for secondary infection in patients with chronic respiratory disease. However, the optimum duration of treatment is less clear. This study suggests that for secondary infection in chronic respiratory disease, 5 day short-course therapy employing antibiotics therapy can be clinically successful. In terms of the economic efficiency of this medical treatment, GFLX is superior to LVFX due to the lower cost of this drug. These results show that therapy involving a 5 day short-course using GFLX is of greater benefit than therapy involving the use of LVFX.

Key word

gatifloxacin, levofloxacin, secondary infection, chronic respiratory disease, 5-day therapy

Received

August 17, 2007

Accepted

October 3, 2007

Jpn. J. Chemother. 55 (6): 451-462, 2007