Comparison of the postantibiotic and postantibiotic sub-MIC effects of levofloxacin and ciprofloxacin on Staphylococcus aureus and Streptococcus pneumoniae

Author:

Licata L1,Smith C E1,Goldschmidt R M1,Barrett J F1,Frosco M1

Affiliation:

1. Department of Microbiology, The R. W. Johnson Pharmaceutical Research Institute, Raritan, New Jersey 08869, USA.

Abstract

The postantibiotic subminimum inhibitory concentration effect (PA SME) may simulate in vivo drug exposure more accurately than the postantibiotic effect (PAE) since subinhibitory concentrations of drug persist between antibiotic dosings. In this study, we compared the PAEs and PA SMEs of levofloxacin and ciprofloxacin for clinical isolates of fluoroquinolone-susceptible Staphylococcus aureus and Streptococcus pneumoniae. At two times the MIC, PAEs of levofloxacin were an average of 0.6 h longer than the PAEs obtained for ciprofloxacin for methicillin-susceptible and methicillin-resistant S. aureus strains. The PAEs of levofloxacin and ciprofloxacin ranged from 1.8 to 3.1 and 1.1 to 2.4 h, respectively. Continued exposure of the methicillin-resistant strain to 1/16, 1/8, and 1/4 the MIC resulted in PA SMEs of 6.5, 15.3, and >22.3 h, respectively, for levofloxacin and 3.8, 8.0, and 12.3 h, respectively, for ciprofloxacin. For isolates of S. pneumoniae, at two times the MIC of both fluoroquinolones, the average PAEs of levofloxacin and ciprofloxacin were equivalent: 1.3 h for the penicillin-susceptible isolate and 0.6 h for the penicillin-resistant isolate. Continued exposure of the penicillin-susceptible S. pneumoniae strain to 1/16, 1/8, and 1/4 the MIC resulted in average PA SMEs of 1.0, 1.4, and 2.8 h, respectively, for levofloxacin and 1.8, 2.0, and 2.5 h, respectively, for ciprofloxacin. Continued exposure of penicillin-resistant S. pneumoniae to 1/16, 1/8, and 1/4 the MIC of the same fluoroquinolones resulted in average PA SMEs of 0.6, 1.1, and 2.9 h, respectively, for levofloxacin and 0.6, 1.1, and 1.5 h, respectively, for ciprofloxacin. The PA SMEs observed demonstrate the superior activity of levofloxacin against methicillin-susceptible or methicillin-resistant S. aureus. Although PAEs were similar for the penicillin-susceptible and penicillin-resistant S. pneumoniae strains, the PA SME of levofloxacin at one-fourth the MIC was longer for penicillin-resistant S. pneumoniae.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference27 articles.

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2. Cars O. and I. Odenholt-Tornqvist. 1993. The post-antibiotic sub-MIC effect in vitro and in vivo. J. Antimicrob. Chemother. 31(Suppl. D):159-166.

3. Craig W. A. and S. Gudmundsson. 1991. The postantibiotic effect p. 403-431. In V. Lorian (ed.) Antibiotics in laboratory medicine 3rd ed. The Williams & Wilkins Co. Baltimore Md.

4. The post-antibiotic suppressive effect of l-ofloxacin, an optically active isomer of ofloxacin;Fu K. P.;Diagn. Microbiol. Infect. Dis.,1992

5. In vitro and in vivo antibacterial activities of levofloxacin (l-ofloxacin), an optically active ofloxacin;Fu K. P.;Antimicrob. Agents Chemother.,1992

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