Quality of life effect of levofloxacin compared to ceftazidime treatment in infective exacerbation of bronchiectasis

Abstract

Background Treatment of infective exacerbation of bronchiectasis with levofloxacin and ceftazidime was shown to have comparable result in sputum parameters and clinical parameters. Clinical parameters, however, do not necessarily reflect the overall impact of an illness on an individual patient. Little is known about the effects of these modes of treatment on the overall well-being of an individual patient. Methods A prospective randomized double blind study was performed to compare sequential intravenous (IV) 500 mg daily for the first three days followed by oral Levofloxacin 500 mg daily for the next seven days to complete 10 days’ course with intravenous Ceftazidime 2 g twice daily for 10 days in treatment of acute exacerbation of bronchiectasis. Sputum, laboratory results and St George respiratory questionnaire, as measure of quality of life, were assessed before and after treatment of the antibiotics. Results Fifty two patients (26 patients in each group) with acute exacerbation were recruited from Sept 2002 to Jan 2004 and randomized to receive either sequential IV/oral Levofloxacin or intravenous Ceftazidime. Both groups of patients showed significant improvement in 24 hour sputum purulence, volume, body temperature, pulse rate, and neutrophil counts. However, symptom domain of St George Respiratory Questionnaire in patients received Levofloxacin treatment showed significant improvement (65.7 on Day 1 and 58.2 on Day 10, P = 0.02) but not in Ceftazidime group (67.4 on Day 1 and 68.7 on Day 10, P = 0.62). Conclusion Sequential intravenous and oral Levofloxacin was equivalent to Ceftazidime treatment for clinical improvement and showed significant advantage in symptoms control over Ceftazidime in treatment of infective exacerbation of bronchiectasis.