We report a multicentric, open trial of intravenous followed by oral
ofloxacin, 400 mg every 12 h, as
therapy for 100 cases of
nosocomial pneumonia and community-acquired
pneumonia requiring hospitalization. The typical subject was 57 yr old, and underlying diseases, such as
chronic obstructive pulmonary diseases (
COPD),
diabetes mellitus, and
congestive heart failure, were common. For 10 subjects previous
therapy had failed. There were 118 pathogens isolated in blood or sputum; S. pneumoniae was the most common (42), followed by H. influenzae (13), Klebsiella spp. (11), and S. aureus (10).
Ofloxacin was administered for an average of 5.7 days intravenously followed by 6.9 days orally. Response to
therapy was judged to be cure in 71 subjects, improvement in 24, and failure in 5. Among the more seriously ill subjects,
ofloxacin therapy was successful for four of five immunocompromised subjects, for 12 of 12 subjects with
nosocomial pneumonia, three of whom were on the
ventilator, and for nine of 10 subjects with community-acquired
pneumonia and
bacteremia, including seven of eight cases due to S. pneumoniae. Univariate risk factor analysis revealed underlying
COPD and/or
tachypnea upon admission to be associated with failure of
ofloxacin therapy, with
bacteremia suggestive of failure. Conversely,
ofloxacin was equally effective in cases in whom previous
therapy failed and in cases of
nosocomial pneumonia, multilobar
pneumonia, and/or
pneumonia due to S. pneumoniae. Results for P. aeruginosa were inconclusive. Intravenous followed by oral
ofloxacin was highly effective in many difficult cases of
pneumonia.