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[Tolerability and safety of levofloxacinin long-term treatment]
Abstract:
Levofloxacin is a useful quinolone for patients infected with osteomyelitis or tuberculosis. There is little information on the tolerance and safety of levofloxacin in long-term treatment. Fifteen patients (10 men and 5 women) with prosthetic joint infection or chronic osteomyelitis were analyzed. The treatment was levofloxacin (500 mg/d) and rifampicin (600 mg/d). Controls were performed monthly during the treatment, and after that every six months. Problems that were likely related to medication were noted by medical interview. Analyses of hepatic and renal function were performed at each visit. The mean age was 64 years. Ten patients had prosthetic joint infection, two chronic osteomyelitis, two osteosynthetic device infection and one silicone graft infection. Staphylococcus aureus was isolated in eight cases, staphylococcus coagulase being negative in five, and the cultures negative in two cases. The mean duration of treatment was 3.6 months (range 2-6 months). No adverse reactions were observed in seven patients (46%). Occasional digestive symptoms were reported in six patients (40%), and two cases (13%) presented light diarrhea. These patients also took antiinflammatory treatment. Sleeplessness was observed in one patient (6%). Tendinitis or alterations in hepatic function were not observed. In no case was the treatment changed due to adverse reactions. It was concluded that levofloxacin is well tolerated and safe and could be an option for infections that require long-term treatment.
Insights
Levofloxacin, combined with rifampicin, shows good tolerance and safety for long-term treatment of bone infections like osteomyelitis. Most patients experienced no adverse reactions, indicating its potential for extended use.
Area of Science:
- Infectious Diseases
- Pharmacology
- Orthopedic Surgery
Background:
- Quinolones, including levofloxacin, are used for osteomyelitis and tuberculosis.
- Limited data exists on the long-term safety and tolerance of levofloxacin.
- Prosthetic joint infections and chronic osteomyelitis often require prolonged antibiotic therapy.
Purpose of the Study:
- To evaluate the safety and tolerance of long-term levofloxacin treatment.
- To assess adverse reactions in patients with bone infections receiving levofloxacin and rifampicin.
Main Methods:
- A cohort of 15 patients with prosthetic joint infection or chronic osteomyelitis was analyzed.
- Patients received levofloxacin (500 mg/d) and rifampicin (600 mg/d) for a mean duration of 3.6 months.
- Adverse reactions were monitored via medical interview, with regular hepatic and renal function tests.
Main Results:
- 46% of patients experienced no adverse reactions.
- Digestive symptoms (40%) and mild diarrhea (13%) were the most common issues.
- No cases of tendinitis or significant hepatic function alterations were observed.
- Treatment was not discontinued in any patient due to adverse events.
Conclusions:
- Levofloxacin, in combination with rifampicin, is well-tolerated and safe for long-term use.
- It presents a viable therapeutic option for bone infections requiring extended treatment durations.
- Further research can explore its efficacy in various complex orthopedic infections.