The efficacy of tosufloxacin tosilate against with Streptococcus pneumoniae community-acquired pneumonia

Shigeru Kohno, Katsunori Yanagihara, Atsushi Saito, Masao Tateyama, Toshiharu Matsushima, Yoshihito Niki, Akira Watanabe, Kazunori Tomono, Nobuki Aoki, Hiromoto Shintani, Koichi Nishi, Yasuyuki Sano, Naohito Suzuki, Hiroshi Sugiura, Shigetoshi Sakai, Kazuhiro Iizuka, Takashi Ida, Hiroshi Hayakawa, Ikko Hashizume, Akio TachibanaKen Ichi Arita, Niro Okimoto, Tadashi Ishida, Shin Kawahara, Atsuhiko Tada, Takeshi Tanimukai, Masatoshi Watanabe, Hirohide Yoneyama, Yukio Matsumoto, Yoshiro Sawae, Masaaki Fukuda, Koji Hashiguchi, Sumio Kawamura, Osamu Sakito, Yuuichi Inoue, Kin Ichi Izumikawa, Kiyoyasu Fukushima, Katsumasa Tokunaga, Yasutsugu Fukuda, Atsushi Maeda, Shun Ichi Kinjo, Mitsuhiko Futenma, Hajime Ohshiro, Yuuei Irabu, Masato Azuma, Taiichi Ohyama, Norifumi Kudeken

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)

    Abstract

    According to the "Japanese Respiratory Society guidelines for the management of community-acquired pneumonia in adults" (hereinafter referred to as "the community-acquired pneumonia guidelines"), fluoroquinolones, such as tosufloxacin tosilate (TFLX) and sparfloxacin (SPFX), are recommended when Streptococcus pneumoniae (S. pneumoniae) is detected. Few clinical studies have been performed, however, of the efficacy and other characteristics of these antimicrobials. This study examined the efficacy of the fluoroquinolone TFLX against S. pneumoniae-related pneumonia with reference to the community-acquired pneumonia guidelines. This study included pneumonia patients where the presence of S. pneumoniae was suspected by smear staining (smear staining-positive patients) and, of these positive patients, where S. pneumoniae was actually detected (S. pneumoniae-detected patients). There was no difference in background characteristics between 68 smear staining-positive patients and 36 S. pneumoniae-detected patients. The efficacy rate was 92.6% (25/27 patients) at a daily dose of 450 mg (450-mg group) and 100% (35/35 patients) at 600 mg (600-mg group) in the smear staining-positive patients. The two non-responders at 450 mg had moderate pneumonia. In S. pneumoniae-detected patients, the efficacy rate was 93.6% (15/16 patients) in the 450-mg group and 100% (16/16 patients) in the 600-mg group. S. pneumoniae disappeared in 94.1% (16/17 patients) in the 450-mg group and 93.8% (15/16 patients) in the 600-mg group. Against S. pneumoniae isolated in this study, MIC90 of TFLX was 0.25 μg/mL. Based on the daily AUC from TFLX concentration in blood from healthy adults, the AUC/MIC ratio was 46.4 in the 450-mg dose and 62.0 in the 600-mg dose. TFLX was effective against S. pneumoniae-related pneumonia in terms of basic aspects of clinical, antimicrobial and pharmacokinetic properties, showing that TFLX is a respiratory quinolone. In patients with S. pneumoniae-related pneumonia, TFLX should be administered to patients with mild and moderate pneumonia at a daily dose of 450 or 600 mg. The higher dose of 600 mg is probably preferable in moderate cases with more potent inflammatory responses according to clinical symptoms and laboratory findings.

    Original languageEnglish
    Pages (from-to)11-19
    Number of pages9
    JournalJapanese Journal of Chemotherapy
    Volume53
    Issue number1
    Publication statusPublished - 2005 Jan

    Keywords

    • Community-acquired pneumonia
    • Post marketing surveillance
    • Streptococcus pneumoniae
    • TFLX
    • Tosufloxacin tosilate

    ASJC Scopus subject areas

    • Pharmacology
    • Pharmacology (medical)

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