From the Research
For a 42-year-old female recovering from a flu-like illness with laboratory findings suggesting a bacterial infection, I recommend empiric treatment with levofloxacin 500mg once daily for 5-7 days, as it has been shown to be effective in treating bacterial infections with a broad spectrum of activity against Gram-positive and Gram-negative bacteria and atypical respiratory pathogens 1. This recommendation is based on the patient's presentation, which includes leukocytosis, thrombocytosis, lymphocytosis, and presence of immature granulocytes, indicating an ongoing inflammatory response likely due to a bacterial infection.
- The patient's age and lack of respiratory symptoms suggest that the infection may be elsewhere, such as the urinary tract or skin.
- Levofloxacin has been shown to be effective in treating a range of infections, including those caused by both penicillin-susceptible and penicillin-resistant strains of S. pneumoniae 1.
- A study comparing levofloxacin and azithromycin plus ceftriaxone in hospitalized adults with moderate to severe community-acquired pneumonia found that levofloxacin was at least as effective as the combination regimen in providing coverage against the current causative pathogens in CAP 2.
- Another study found that levofloxacin was as effective as amoxicillin/clavulanate plus clarithromycin in clinical and microbiological responses in hospitalized patients with community-acquired pneumonia 3.
- While there are concerns about the cardiac risks associated with levofloxacin and azithromycin, the benefits of antibacterial therapies should be considered when making prescription decisions, and the potential risks must be understood 4.
- It is essential to identify the source of infection through a thorough physical examination and to reassess treatment after 48-72 hours based on clinical response.
- The patient should be advised to maintain adequate hydration and rest during recovery.