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Published on: June 5, 2012
In vitro activity of levofloxacin and FK-037 against aerobic isolates from spontaneous bacterial peritonitis
M G Cormican1, B A Runyon, R N Jones
1Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242, USA.
Abstract:
Spontaneous bacterial peritonitis is a potentially fatal complication of ascites, most often caused by the Enterobacteriaceae or streptococci. We have evaluated the in vitro activity of FK-037, a new cephalosporin, cefotaxime, cefpirome, ceftazidime, levofloxacin, and ofloxacin against a collection of 124 isolates from patients with spontaneous bacterial peritonitis. Levofloxacin (< or = 2 mg/L) was active against all isolates and ofloxacin (< or = 2 mg/L) against 98.4% of isolates. The cephalosporins (< or = 8 mg/L) were less active against cefpirome = 95.4%, FK-037 = 94.4%, and cefotaxime and ceftazidime = 91.1%. Given the high mortality associated with spontaneous bacterial peritonitis, clinical studies of the quinolones (specifically of levofloxacin) and the alternative cephalosporins presented for treatment of spontaneous bacterial peritonitis appears warranted.
Insights
Levofloxacin and ofloxacin show high in vitro activity against bacteria causing spontaneous bacterial peritonitis. These fluoroquinolones, alongside alternative cephalosporins, warrant clinical evaluation for treating this serious infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Spontaneous bacterial peritonitis (SBP) is a severe complication of ascites.
- Enterobacteriaceae and streptococci are common causative agents of SBP.
Purpose of the Study:
- To evaluate the in vitro antimicrobial activity of FK-037, cefotaxime, cefpirome, ceftazidime, levofloxacin, and ofloxacin.
- To compare the efficacy of these agents against SBP isolates.
Main Methods:
- In vitro susceptibility testing of 124 bacterial isolates from SBP patients.
- Agents tested included a new cephalosporin (FK-037) and established antibiotics.
Main Results:
- Levofloxacin demonstrated activity against 100% of isolates at <= 2 mg/L.
- Ofloxacin showed activity against 98.4% of isolates at <= 2 mg/L.
- Cephalosporins exhibited lower activity: cefpirome (95.4%), FK-037 (94.4%), cefotaxime and ceftazidime (91.1%) at <= 8 mg/L.
Conclusions:
- Fluoroquinolones, particularly levofloxacin, show promising in vitro activity against SBP pathogens.
- Alternative cephalosporins also warrant consideration.
- Clinical studies are recommended to assess the therapeutic potential of these agents in treating SBP.
