Pharmacodynamics of levofloxacin and ofloxacin against Streptococcus pneumoniae

The aim of this study was to compare the bactericidal efficacy of levofloxacin and ofloxacin against Streptococcus pneumoniae at different dosage regimens for both agents. An in-vitro pharmacodynamic model was used. Levofloxacin kinetics of 500 mg, administered od or bd, were compared with ofloxacin kinetics of 400 mg od or bd. Killing by 3 log 10 (99.9%) was achieved up to an MIC of 0.5 mg/L (500 mg od) or 1 mg/L (500 mg bd). For levofloxacin killing of S. pneumoniae was unimpaired in mixed cultures with Haemophilus influenzae. For ofloxacin, killing by 2 log 10 was achieved up to an MIC of 0.5 mg/L for 400 mg od and up to an MIC of 1 mg/L for 400 mg bd. Killing by 3 log 10 was not achievable by 400 mg od, but was achieved up to an MIC of 0.5 mg/L for 400 mg bd. Killing of S. pneumoniae with identical MICs of levofloxacin was not influenced by their susceptibility to penicillin G. These data, together with the two-fold higher activity of levofloxacin in comparison with ofloxacin, indicate good therapeutic perspectives for levofloxacin over ofloxacin in the treatment of S. pneumoniae infections.