PURPOSE: To value the effect of quinolone therapy in lung cancer resected patients with nosocomial pulmonary infection.
METHODS: A multicentric study is reported on 38 complicated patients and submitted to pulmonary resection for cancer after prophylaxis with cephalosporin. The patients developed a microbiological tested pulmonary infection after resection procedure. A history of chronic bronchopulmonary disease was present in 26 cases, bronchial asthma in 4. The isolated pathogens on bronchoalveolar lavage were Haemophilus influenzae (no. 15), Streptococcus pneumoniae (no. 11), Moraxella catarrhalis (no. 3), Mycoplasma pneumoniae (no. 7), Chlamydia pneumoniae (no. 1) and Legionella pneumophila (no. 1). A quinolone, the Levofloxacin, was employed to the dosing of 500 mg IV twice day for 10 days. The patients have been observed for 10 days by the basal find of nosocomial infection after pulmonary resection. The basal sputum results positive in 8 cases as also to the first control at 4th day of therapy, without presence of pathogens at the 2nd test. The basal bronchoalveolar lavage results positive in the remainders 30 cases as also in 4th day, and it has been positive at the 2nd test in alone 2 cases, but with reduction of the bacterial count. All the isolated pathogens were sensitive in vitro to Levofloxacin.
RESULTS: There was a clinical improvement with resolution of the symptoms in 36/38. Eradication was in 34 cases about the pathogen in cause and a presumed eradication in 2 ones: in the remainders 2, the partial eradication in 1, while in the last one there was a colonization. Five patients had diarrhea for about 5 days, 3 headache for 2 days of which 1 with nausea and 1 asthenia for 6 days.
CONCLUSION: On the escort of the microbiological finds the effected therapy has allowed to not only reach the microbiological eradication but also a clean improvement of the symptoms with reduction of the postoperative hospitalization.
CLINICAL IMPLICATIONS: The clean improvement of the symptoms with reduction of the postoperative hospitalization increased reduces the costs of admission.
DISCLOSURE: Cosimo Lequaglie, None.
Cosimo Lequaglie MD * Gabriella Giudice MD Centro di Riferimento Oncologico Basilicata, Rionero in Vulture, Italy
COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group