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In the present paper, the synchronous fluorimetric spectra of norfloxacin, lomefloxacin chlorhydric acid, and levofloxacin lactate with deltalambda = 190 nm in a B-R buffer medium of pH 2.87 were measured, and the partial least squares (PLS) method was applied to the quantitative resolution of the seriously overlapped fluorimetric spectra of these compounds. The linear ranges for norfloxacin, lomefloxacin chlorhydric acid, and levofloxacin lactate are 0.016-0.40 microg x mL(-1), 0.01-0.336 microg x mL(-1) and 0.01-0.336 microg x mL(-1), respectively. The limits of detection are 0.012 6 microg x mL(-1) for norfloxacin, 0.006 microg x mL(-1) for lomefloxacin chlorhydric acid, and 0.007 2 microg x mL(-1) for levofloxacin lactate. The analytical results by PLS were compared with principal components regression (PCR) and classical least squares (CLS), and this method was applied to the determination of these three compounds in eel samples with satisfactory results.
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Antibiotic resistance has resulted in unsatisfactory eradication results with dual and now triple therapy in many countries. Newer antibiotics and changes in dosing and duration of therapy may overcome resistant strains but may only provide limited improvement in eradication rates. Sequential therapy with amoxicillin (1 g twice a day) and a proton pump inhibitor (PPI) (twice a day) given for 5 days followed by a PPI plus clarithromycin (500 mg twice a day) and tinidazole (500 mg twice a day) for 5 days is now a first-line therapy for Helicobacter pylori in some countries. Standard triple therapy is effective in regions where clarithromycin resistance is low. Levofloxacin based triple therapy is an effective alternative to quadruple therapy in second-line treatment. Adjuvant therapy may reduce side-effects and improve compliance. Molecular and genomic research on H. pylori may result in the development of targeted antibiotic therapy; however, more research is required in this field. Further research in vaccination is also necessary before this can become an option in clinical practice.
Here we describe a cluster of hospital-acquired Clostridium difficile infections (CDI) among 26 patients with osteoarticular infections. The aim of the study was to define the source of C. difficile and to evaluate the impact of general infection control measures and antibiotic stewardship on the incidence of CDI.
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The activity of trovafloxacin, a new fluorinated naphtheridone, was tested against 61 Legionella spp. isolates and compared with that of 4 fluoroquinolones, 2 macrolides, and rifampin. Trovafloxacin MICs were determined by a reference agar dilution method and E-test (Solna, Sweden) strips on buffered charcoal yeast extract agar. Among the fluoroquinolone compounds, the rank order of activity (on the basis of MIC90 results) determined with E-test strips was as follows: levofloxacin (MIC90, 0.094 microgram/ml) > trovafloxacin = sparfloxacin = ofloxacin (MIC90, 0.19 microgram/ml). Rifampin (MIC90, 0.008 microgram/ ml) and clarithromycin (MIC90, 0.032 microgram/ml) were the most potent of all drugs tested, and erythromycin and ciprofloxacin were the least active. In this study, the E-test strips with trovafloxacin were validated (100% of results +/- one log2 dilution compared to the reference value) for susceptibility testing with Legionella isolates.
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Twenty-five cases of SCAP due to L. pneumophila were included, and 7 patients (28%) out of 25 died after a median of 7 days of mechanical ventilation. Fifteen patients (60%) presented shock. Levofloxacin and clarithromycin were the antibiotics most commonly used in monotherapy, while the most frequent combination was rifampicin plus clarithromycin. Patients subjected to combination therapy presented a lower mortality rate versus patients subjected to monotherapy (odds ratio for death [OR] 0.15; 95%CI 0.02-1.04; p=0.08). In patients with shock, this association was stronger and proved statistically significant (OR for death 0.06; 95%CI 0.004-0.86; p=0.04).
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The pharmacokinetics aspects of levofloxacin were studied in healthy and experimentally renal damaged Muscovy ducks after single intravenous (IV) and oral (PO) dose of 10 mg kg(-1) bwt. Following IV administration, elimination half-life (t 1/2( β )) and mean residence time (MRT) were longer in renal damaged ducks than in healthy ones. Total clearance (Cltot) in renal damaged ducks (0.20 L kg(-1) h(-1)) was significantly lower as compared to that in healthy ones (0.41 L kg(-1) h(-1)). Following PO administration, the peak serum concentration (C max) was higher in renal damaged than in healthy ducks and was achieved at maximum time (t max) of 2.47 and 2.05 h, respectively. The drug was eliminated (t 1/2(el)) at a significant slower rate (3.94 h) in renal damaged than in healthy ducks (2.89 h). The pharmacokinetic profile of levofloxacin is altered in renal damaged ducks due to the increased serum levofloxacin concentrations compared with that in clinically healthy ducks. Oral administration of levofloxacin at 10 mg kg(-1) bwt may be highly efficacious against susceptible bacteria in ducks. Also, the dose of levofloxacin should be reduced in renal damaged ducks. Pharmacokinetic/pharmacodynamic integration revealed significantly higher values for C max/MIC and AUC/MIC ratios in renal damaged ducks than in healthy ones, indicating the excellent pharmacokinetic characteristics of levofloxacin in renal damaged ducks.
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Staphylococcal prosthesis joint infections were defined by positive culture of joint aspirate, intraoperative debridement specimens, or sinus tract discharge in the presence of clinical criteria. Patients received long-term oral levofloxacin 500 mg and rifampicin 600 mg once per day. Sixty patients (age 74.6+/-8.4 years) were included.