Bacterial nosocomial pneumonia treatment

Ciprofloxacin is a fluoroquinolone antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of infections of the lower respiratory tract, skin and skin structure, bones and joints, urinary tract gonorrhea, chancroid, and infectious diarrhea caused by susceptible strains of specific organisms typhoid fever uncomplicated cervical and urethral gonorrhea women with acute uncomplicated cystitis acute sinusitis nosocomial pneumonia chronic bacterial prostatitis complicated intra-abdominal infections reduction of incidence or progression of inhalational anthrax following exposure to aerosolized Bacillus anthracis. Cipro IV Used for empirical therapy for febrile neutropenic patients. 

Levofloxacin is a fluoroquinolone/ophthalmic/antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, nosocomial pneumonia, community-acquired pneumonia, skin and skin structure infections, chronic bacterial prostatitis, urinary tract infection (UTI), inhalational anthrax (postexposure), and acute pyelonephritis caused by susceptible strains of specific microorganisms. Ophthalmic use is for the treatment of conjunctivitis caused by susceptible strains of aerobic Gram-positive and aerobic Gram-negative microorganisms. 

Bacterial overgrowth frequently occurs as consequence of acid inhibition in humans but is of little clinical consequence. Neither gastrointestinal infections nor nosocomial pneumonia in intensive care medicine are significantly increased. Increased formation of iV-nitroso compounds in the stomach after omeprazole treatment has not been found. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

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