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Annals of Palliative Medicine Sep 2021The efficacy of levofloxacin and ciprofloxacin in the treatment of urinary tract infection is not clear yet. This study perform a meta-analysis to explore the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The efficacy of levofloxacin and ciprofloxacin in the treatment of urinary tract infection is not clear yet. This study perform a meta-analysis to explore the differences between the two against urinary tract infection (UTI).
METHODS
A computerized literature search was conducted of the databases of PubMed, Medline, Embase, and the Cochrane Library. All the retrieved literatures were randomized comparative studies of levofloxacin and ciprofloxacin. The included studies were screened according to the standard of nanofiltration. The risk of bias was assessed with RevMan 5.3.5 software. The treatment effect index and incidence of adverse reactions index were established and compared via meta-analysis.
RESULTS
A total of 5 studies were included, involving 2,877 patients overall. The results showed that levofloxacin was more effective than ciprofloxacin, but the difference between the 2 drugs was not statistically significant [odds ratio (OR) =1.18, 95% confidence interval (CI): 0.94 to 1.46, P=0.15]. There was also no statistical significance in the rate of adverse reactions between the 2 drugs (OR =0.91, 95% CI: 0.78 to 1.07, P=0.27).
DISCUSSION
In the treatment of UTI, the efficacy and safety of levofloxacin and ciprofloxacin are similar statistically. If bacterial resistance is discovered after the treatment of one of the drugs, the other drug might become an alternative.
Topics: Ciprofloxacin; Humans; Levofloxacin; Urinary Tract Infections
PubMed: 34628902
DOI: 10.21037/apm-21-2042 -
International Journal of Clinical... Dec 2023Quinolones can cause rhabdomyolysis, but rhabdomyolysis secondary to quinolone use is uncommon, and few reports associate rhabdomyolysis with levofloxacin use. We report...
Quinolones can cause rhabdomyolysis, but rhabdomyolysis secondary to quinolone use is uncommon, and few reports associate rhabdomyolysis with levofloxacin use. We report a case of acute rhabdomyolysis associated with levofloxacin use. A 58-year-old Chinese woman developed myalgia and difficulty walking ~ 4 days after taking levofloxacin for a respiratory infection. Blood biochemistry revealed elevated peripheral creatine kinase and liver enzyme levels, but the patient did not develop an acute kidney injury. Her symptoms resolved after discontinuation of levofloxacin. This case report highlights the need for monitoring of blood biochemistry in patients taking levofloxacin to enable early diagnosis and treatment of potentially life-threatening myositis.
Topics: Female; Humans; Middle Aged; Levofloxacin; Respiratory Tract Infections; Rhabdomyolysis; Acute Kidney Injury
PubMed: 37114513
DOI: 10.5414/CP204377 -
Expert Opinion on Drug Safety Nov 2019: Ciprofloxacin, levofloxacin, and moxifloxacin belong to the fluoroquinolone class of antibiotics and are amongst the most commonly prescribed antibiotics. In 2018 and... (Review)
Review
An evaluation of reports of ciprofloxacin, levofloxacin, and moxifloxacin-association neuropsychiatric toxicities, long-term disability, and aortic aneurysms/dissections disseminated by the Food and Drug Administration and the European Medicines Agency.
: Ciprofloxacin, levofloxacin, and moxifloxacin belong to the fluoroquinolone class of antibiotics and are amongst the most commonly prescribed antibiotics. In 2018 and 2019, Food and Drug Administration (FDA) and the European Medicine Agency (EMA) requested that manufacturers harmonize FQ safety information related to neuropsychiatric, aortic dissection, and long-term disability. The authors hypothesize that FDA and EMA epidemiologists support a strong association between these drugs and the three toxicities. : Studies of FQ-associated neuropsychiatric toxicity, long-term disability, and aortic ruptures/dissections. Clinical sources include FDA Advisory Committee documents, a 2014 Citizen Petition filed with the FDA requesting safety information additions to FQ labels for neuropsychiatric toxicities (partially granted in 2018), an under-review Citizen Petition under review by the FDA requesting a FQ Risk Evaluation and Mitigation Strategy, and safety notifications from the EMA. : FDA and the EMA report state that neuropsychiatric toxicity, long-term disability, and aortic dissections//aneurysms occur with all FQs. Disability and neuropsychiatric toxicity can occur after one dose or several months after FQs. United States' and European' regulators warn physicians not to prescribe FQs for uncomplicated acute urinary tract infection, sinusitis, or bronchitis, unless other possible choices are tried first, as risks outweigh benefits in these settings.
Topics: Aortic Dissection; Animals; Anti-Bacterial Agents; Aortic Aneurysm; Aortic Rupture; Ciprofloxacin; Disability Evaluation; European Union; Humans; Levofloxacin; Moxifloxacin; Neurotoxicity Syndromes; United States; United States Food and Drug Administration
PubMed: 31500468
DOI: 10.1080/14740338.2019.1665022 -
Journal of Materials Chemistry. B Sep 2023Carbon dot (CD)-based nanozymes have great potential in antibacterial applications. In order to achieve enhanced broad-spectrum antibacterial capacity, we synthesized...
Carbon dot (CD)-based nanozymes have great potential in antibacterial applications. In order to achieve enhanced broad-spectrum antibacterial capacity, we synthesized Co-doped drug-based CDs (Co-Lvx-CDs) using levofloxacin and vitamin B12 as precursors by mimicking the catalysis of antibacterial activity of natural enzymes. The Co-Lvx-CDs retained not only the effective functional groups of the traditional antibiotic levofloxacin but also achieved oxidase-like and peroxidase-like activities to generate reactive oxygen species (ROS) through Co doping. Additionally, the Co-Lvx-CDs had superb fluorescence properties and could be applied in information encryption. The CDs were validated to have a broad-spectrum bactericidal effect against Gram-positive and -negative bacteria, compensating for the limitations of levofloxacin while also having enhanced sterilization ability. Importantly, the proposed Co-Lvx-CDs provide a new idea for the design of multifunctional CD-based nanozymes with preconceived outcomes.
Topics: Levofloxacin; Carbon; Anti-Bacterial Agents; Catalysis
PubMed: 37545365
DOI: 10.1039/d3tb01376f -
PloS One 2023Helicobacter pylori treatment failure remains a challenging problem. This study aimed to identify predictive factors for successful eradication in patients following... (Clinical Trial)
Clinical Trial
BACKGROUND
Helicobacter pylori treatment failure remains a challenging problem. This study aimed to identify predictive factors for successful eradication in patients following treatment failures.
METHODS
This was a retrospective cohort study. This study included 1,050 dyspeptic patients diagnosed with H. pylori infection at tertiary care center in Thailand between March 2014 and October 2021. Patients' demographic data, endoscopic findings, H. pylori culture, antimicrobial susceptibility testing (AST), treatment regimens and outcomes were analysed.
RESULTS
Of 1,050 patients with H. pylori infections, 302 (28.7%) experienced treatment failure (mean age 58.4 years; 44.7% males). AST was performed in 192. Resistance was observed for metronidazole (43.2%), levofloxacin (33.9%), clarithromycin (24%), and amoxicillin (2.1%). There was no tetracycline resistance. Multidrug-resistance (MDR) was significantly more common following treatment failure (45.5% vs. 15.7%, p<0.001). Baseline characteristics were similar between treatment successes and failures. Eradication rates after first-line and second-line regimens were 71.2% and 54.5%, respectively. Medication nonadherence [OR 36.6 (95%CI 8.65-155.03, p<0.001)] and MDR [OR 4.49 (95%CI 2.29-8.81, p<0.001)] were associated with treatment failure. Over time, resistance increased for metronidazole, levofloxacin, and clarithromycin, while eradication rates with triple therapy declined. Tailored antibiotic therapy [OR 4.92 (95%CI 1.61-14.99, p = 0.005)] and a regimen including 4-times-daily dosing of amoxicillin (2 grams/day) [OR 3.05 (95%CI 1.10-8.41, p = 0.032)] were significantly associated with treatment success after first-line failure. Eradication rates when using tailored therapy and 4-times-daily dosing of amoxicillin (2 grams/day) were 91.1% and 89.4%, respectively. Performing AST before first-line therapy resulted in the highest cure rates. AST performed after multiple treatment failures was also associated with higher eradication rates compared with the group without AST (94.4% vs. 50%,p = 0.008).
CONCLUSIONS
AST either before or after treatment failure correlated with a higher proportion of successful eradication. Nonadherence and the MDR infections predicted treatment failure. Tailored therapy and 4-times-daily dosing of amoxicillin after treatment failure were likely to be successful.
Topics: Female; Humans; Male; Middle Aged; Amoxicillin; Anti-Bacterial Agents; Clarithromycin; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Levofloxacin; Metronidazole; Retrospective Studies; Treatment Failure
PubMed: 38033026
DOI: 10.1371/journal.pone.0294403 -
Archives of Biochemistry and Biophysics Dec 2021Neurodegenerative diseases are a group of debilitating maladies involving protein aggregation. To this day, all advances in neurodegenerative disease therapeutics have...
Neurodegenerative diseases are a group of debilitating maladies involving protein aggregation. To this day, all advances in neurodegenerative disease therapeutics have helped symptomatically but have not prevented the root cause of the disease, i.e., the aggregation of involved proteins. Antibiotics are becoming increasingly obsolete due to the rising multidrug resistance strains of bacteria. Thus, antibiotics, if put to different use as therapeutics against other diseases, could pave a new direction to the world of antibiotics. Hence, we studied the antibiotic levofloxacin for its potential anti-amyloidogenic behavior using human lysozyme, a protein involved in non-systemic amyloidosis, as a model system. At the sub-stoichiometric level, levofloxacin was able to inhibit amyloid formation in human lysozyme as observed by various spectroscopic and microscopic methods, with IC values as low as 8.8 ± 0.1 μM. Levofloxacin also displayed a retarding effect on seeding phenomena by elongating the lag-phase (from 0 to 88 h) at lower concentration, and arresting lysozyme fibrillation at the lag stage in sub-stoichiometric concentrations. Structural and computational analyses provided mechanistic insight showing that levofloxacin stabilizes the lysozyme in the native state by binding to the aggregation-prone residues, and thereby inhibiting amyloid fibrillation. Levofloxacin also showed the property of disrupting amyloid fibrils into a smaller polymeric form of proteins which were less cytotoxic as confirmed by hemolytic assay. Therefore, we throw new light on levofloxacin as an amyloid inhibitor and disruptor which could pave way to utilization of levofloxacin as a potential therapeutic against non-systemic amyloidosis and neurodegenerative diseases.
Topics: Amyloid; Anti-Bacterial Agents; Circular Dichroism; Drug Resistance, Multiple, Bacterial; Humans; Levofloxacin; Molecular Docking Simulation; Molecular Dynamics Simulation; Point Mutation; Spectrometry, Fluorescence
PubMed: 34728171
DOI: 10.1016/j.abb.2021.109077 -
Molecules (Basel, Switzerland) May 2022Tympanic membrane perforation (TMP), a common disease, often needs a scaffold as the patch to support surgery. Due to the environment of auditory meatus, the patch can...
Tympanic membrane perforation (TMP), a common disease, often needs a scaffold as the patch to support surgery. Due to the environment of auditory meatus, the patch can be infected by bacteria that results in failure; therefore, the ideal scaffold may combine biomimetic and antibacterial features. In this work, gelatin was used as the electrospinning framework, genipin as the crosslinking agent, and levofloxacin as an antibacterial in order to prepare the scaffold for TMP. Different contents of levofloxacin have been added to gelatin/genipin. It was found that, with the addition of levofloxacin, the gelatin/genipin membranes exhibit improved hydrophilia and enhanced tensile strength. The antibacterial and cell-cultured experiments showed that the prepared antibacterial membranes had excellent antibacterial properties and good biocompatibility, respectively. In summary, levofloxacin is a good group for the gelatin/genipin scaffold because it improves the physical properties and antibacterial action. Compared with different amounts of levofloxacin, a gelatin/genipin membrane with 1% levofloxacin is more suitable for a TM.
Topics: Anti-Bacterial Agents; Gelatin; Iridoids; Levofloxacin; Nanofibers; Tissue Scaffolds; Tympanic Membrane
PubMed: 35566258
DOI: 10.3390/molecules27092906 -
Expert Opinion on Pharmacotherapy Apr 2020Urinary tract infections (UTIs) are among the most common causes of sepsis presenting to hospitals. Treating complicated UTIs is extremely important due to their...
INTRODUCTION
Urinary tract infections (UTIs) are among the most common causes of sepsis presenting to hospitals. Treating complicated UTIs is extremely important due to their potential mortality. Levofloxacin is a fluoroquinolone antibacterial that has become one of the cornerstones of antibiotic therapy of complicated UTIs and pyelonephritis since its introduction in the 1990s because of its exceptional pharmacokinetic (PK) and pharmacodynamic (PD) profile. However, the emergence of widespread fluoroquinolone resistance over the past decade has prompted investigators to reexamine its place in the treatment of UTI.
AREAS COVERED
This literature review summarizes data about the efficacy and the tolerability of levofloxacin in treating complicated UTIs and pyelonephritis.
EXPERT OPINION
In the early 2000s, fluoroquinolones became the most commonly prescribed antibiotic in the US. Since then, the resistance rate of to fluoroquinolones has increased, largely hampering the use of this class of drugs. These data, in association with emerging data about inappropriate prescription and toxicity, have limited its clinical use. For these reasons, a judicious use of levofloxacin and other fluoroquinolones and a careful implementation of infection control procedures are the main available tools for the management of UTIs and pyelonephritis.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Female; Humans; Infection Control; Levofloxacin; Pyelonephritis; Sepsis; Urinary Tract Infections
PubMed: 32004097
DOI: 10.1080/14656566.2020.1720647 -
Archives of Razi Institute Oct 2022The presence of efflux pumps genes in , such as and , is critical for ciprofloxacin and levofloxacin resistance. This study examined the efflux pump gene expression and...
The presence of efflux pumps genes in , such as and , is critical for ciprofloxacin and levofloxacin resistance. This study examined the efflux pump gene expression and activity in ciprofloxacin and levofloxacin-resistant strains. Twenty clinical samples of wounds and burns were collected. strains were tested using specific culture media. Antibiotic susceptibility testing was done using the disc diffusion method. After determining the disc diffusion method of ciprofloxacin and levofloxacin, Methicillin-resistant (MRSA) isolates were found in ten of the twenty clinical samples. The susceptibility of in the study revealed 40% ciprofloxacin resistance and 20% levofloxacin resistance. The gene expression of and efflux pump genes was assessed using Real-Time PCR. The nor A gene was detected in all ciprofloxacin-resistant pathogens, and gene expression increased in samples treated with ciprofloxacin compared to samples not treated with ciprofloxacin results of a real-time PCR test. The gene was detected in resistant strains, and its expression increased, as was the case with the gene. The fold of gene expression of gene for the ten isolates ranged from (12.082 to 42.81 fold) and also this result was higher than the fold of gene (0.0036-34.05 fold). The research study discovered that efflux pump genes play a crucial role in ciprofloxacin and levofloxacin resistance. Also, when employed as a housekeeping gene in gene expression, the gene produced excellent results.
Topics: Bacterial Proteins; Ciprofloxacin; Gene Expression; Levofloxacin; Methicillin-Resistant Staphylococcus aureus; Multidrug Resistance-Associated Proteins; RNA, Ribosomal, 16S; Staphylococcal Infections; Staphylococcus aureus; Humans
PubMed: 37123124
DOI: 10.22092/ARI.2022.358335.2197 -
The Journal of Infectious Diseases Dec 2022Helicobacter pylori eradication regimens should be guided by antimicrobial susceptibility testing. The objective of this study was to evaluate the molecular-based...
BACKGROUND
Helicobacter pylori eradication regimens should be guided by antimicrobial susceptibility testing. The objective of this study was to evaluate the molecular-based Mosprie assay for detecting H. pylori resistance to clarithromycin and levofloxacin using gastric biopsies.
METHODS
A total of 185 culture-positive frozen gastric biopsies were included for Mosprie assay and also for 23S rRNA and gyrA gene sequencing. The susceptibility results by the Mosprie assay were compared with the E-test results retrospectively retrieved. The discordant results were analyzed by sequencing of the 23S rRNA and gyrA genes.
RESULTS
Susceptibility concordance between the Mosprie assay and E-test for clarithromycin and levofloxacin was 97.30% (180/185) and 88.11% (163/185), respectively. The full agreement between clarithromycin genotypes by Mosprie assay and the 23S rRNA sequencing results was observed in the 5 samples with discordant Mosprie assay and E-test results. However, for levofloxacin, of the 16 discordant samples with resistant phenotype but a susceptible genotype by Mosprie assay, 6 were found to have levofloxacin resistance-related gyrA gene mutations.
CONCLUSIONS
The rapid and reliable Mosprie assay can be recommended for H. pylori susceptibility testing of clarithromycin and levofloxacin on gastric biopsies. Future technical improvements are needed in detecting levofloxacin resistance-associated gene mutations.
Topics: Clarithromycin; Levofloxacin; Helicobacter pylori; Retrospective Studies
PubMed: 36478246
DOI: 10.1093/infdis/jiac402