International Ofloxacin Symposium – Closing Remarks

Prof. E. Rubinstein, Chaim Sheba Medical Center, Tel Aviv University, 52621 Tel Hashomer (Israel) This symposium has touched three points that are currently in the focus of medical attention, namely drug therapy in the elderly, the care of the immunocompromised host and the cost benefit of antibiotic therapy. The elderly are the fastest growing segment in our population. In the developed world, every 10 years the average life span increases by 1 year. This segment of population – people over 70 years – consume two thirds of current medical resources. Infectious diseases in the elderly manifest themselves differently than in the younger population, antibiotic therapy of these infections is not yet established and the end points of therapy are not well defined. Following the explanation of the mechanism of action of ofloxacin on bacteria and its relative absence of interaction with eucaryotic cells – delivered by Prof. J.T. Smith (UK) – Prof. M. Yamaoka (Japan) reported on the use of ofloxacin in elderly patients (mean age 82 years) with pneumonia – during therapy, he observed a slight improvement in several immunological parameters that accompanied the clinical improvement in these elderly patients. Prof. Yamaoka stressed the relative safety of ofloxacin in the aged. Prof. H. Giama-rellou (Greece) treated elderly patients with urinary tract infections and with asymptomatic bacteriuria with 3 weeks of ofloxacin therapy (400 mg once daily) and found it to be safe and better tolerated than co-trimoxazole. Interestingly, no ofloxacin-resistant bacteria were isolated in the ofloxacin-treated patients. These two papers suggest that ofloxacin therapy in the aged might be both effective and safe. It is clear, however, that a large body of information is required in order to ascertain the exact role of ofloxacin in the treatment of aged patients. Prof. H. Sawada (Japan) reported on the use of ofloxacin in the prevention and therapy of bacterial infections in neutropenic patients with hematologic malignancies. The period of prophylaxis ranged from 7 to 156 days and was efficacious in 75.3% of the cases. This efficacy rate decreased with the length of the period of leukopenia and consequently with the amount of drug administered. Additional 17 episodes of infections were treated by the same authors in neutropenic patients with ofloxacin with an efficacy rate of 65%. Ofloxacin in all these patients was reInternational Ofloxacin Symposium – Closing Remarks 69