ArticleAntimicrobial agents and chemotherapy2009
Effect of differences in MIC values on clinical outcomes in patients with bloodstream infections caused by gram-negative organisms treated with levofloxacin.
Article in Antimicrobial agents and chemotherapy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of antibiotic MIC on infection outcome in patients with susceptible Gram-negative bacteria: a systematic review and meta-analysis.Antimicrobial agents and chemotherapy · 2012Pooled it
- Influence of borderline cefepime MIC on the outcome of cefepime-susceptible Pseudomonas aeruginosa bacteremia treated with a maximal cefepime dose: a hospital-based retrospective study.Annals of clinical microbiology and antimicrobials · 2017Trial
- Beyond β-Lactams: Defining the Role of Eravacycline in Multidrug-Resistant and Metallo-β-Lactamase-Producing Infections.Antibiotics (Basel, Switzerland) · 2026Review
- The Rise, Fall, and Rethink of (Fluoro)quinolones: A Quick Rundown.Pathogens (Basel, Switzerland) · 2025Review
- Impact of Persistent Multidrug-Resistant Gram-Negative Bacteremia on Clinical Outcome and Mortality.Antibiotics (Basel, Switzerland) · 2023Article
- The relationship between minimum inhibitory concentration and 28 day mortality in patients with a Gram-negative bloodstream infection: an analysis of data from a cohort study (BSI-FOO).JAC-antimicrobial resistance · 2023Article
- Evaluating outcomes associated with revised fluoroquinolone breakpoints for Enterobacterales urinary tract infections: A retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Article
- Clinical Impact of the Revised 2019 CLSI Levofloxacin Breakpoints in Patients withAntimicrobial agents and chemotherapy · 2021Article
- Fluoroquinolone Versus Nonfluoroquinolone Treatment of Bloodstream Infections Caused by Chromosomally Mediated AmpC-Producing Enterobacteriaceae.Antibiotics (Basel, Switzerland) · 2020Article
- Impact of Reappraisal of Fluoroquinolone Minimum Inhibitory Concentration Susceptibility Breakpoints in Gram-Negative Bloodstream Isolates.Antibiotics (Basel, Switzerland) · 2020Article
- Predicting antimicrobial resistance in Pseudomonas aeruginosa with machine learning-enabled molecular diagnostics.EMBO molecular medicine · 2020Article
- Don't Get Wound Up: Revised Fluoroquinolone Breakpoints for Enterobacteriaceae and Pseudomonas aeruginosa.Journal of clinical microbiology · 2019Review
- Clinical Outcomes of Extended-Spectrum Beta-Lactamase-ProducingThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2018Article
- Identification of Plasmid-Mediated Quinolone Resistance in Salmonella Isolated from Swine Ceca and Retail Pork Chops in the United States.Antimicrobial agents and chemotherapy · 2017Article
- Moxifloxacin's Limited Efficacy in the Hollow-Fiber Model of Mycobacterium abscessus Disease.Antimicrobial agents and chemotherapy · 2016Article
- Clinical outcomes of Enterobacteriaceae infections stratified by carbapenem MICs.Journal of clinical microbiology · 2015Article
- Occurrence of classes I and II integrons in Enterobacteriaceae collected from Zagazig University Hospitals, Egypt.Frontiers in microbiology · 2015Article
- Plasmid-mediated quinolone resistance.Microbiology spectrum · 2014Review
- Personalized therapeutics for levofloxacin: a focus on pharmacokinetic concerns.Therapeutics and clinical risk management · 2014Review
- Molecular characterization of extraintestinal Escherichia coli isolates in Japan: relationship between sequence types and mutation patterns of quinolone resistance-determining regions analyzed by pyrosequencing.Journal of clinical microbiology · 2013Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Emerging evidence suggests that current fluoroquinolone dosing strategies may be inadequate to treat bloodstream infections caused by organisms classified as sensitive. This study sought to determine if differences in MICs for levofloxacin-susceptible gram-negative organisms correlate with differences in patient outcomes. A retrospective cohort study evaluated patients treated with levofloxacin for bloodstream infections caused by susceptible gram-negative organisms. Patients infected with gram-negative organisms for which MICs indicated susceptibility were categorized into three groups: those with organisms for which MICs were low (<or=0.25 mg/liter), intermediate (0.5 mg/liter), and high (1 or 2 mg/liter). Patients were evaluated for baseline similarity, all-cause mortality, and measurements of morbidity. A total of 404 patients with bloodstream infections caused by gram-negative organisms were identified. Of these patients, 312 were treated with levofloxacin and included in the analysis. No significant difference in all-cause mortality among the three groups was observed. The high-MIC group had a significantly longer average hospital stay postculture than the low- and intermediate-MIC groups (16.4 days versus 7.3 and 7.9 days; P < 0.01) and a significantly longer duration of infection (2.1 days versus 1.0 and 1.2 days; P < 0.001). Multivariate analysis adjusting for covariates revealed that a high MIC was associated with an increase of 5.67 days (95% confidence interval, 0.77 to 10.62 days; P = 0.02) in the mean length of stay postculture compared to the mean length of stay for the low-MIC group. Patients treated with levofloxacin for bloodstream infections caused by gram-negative organisms for which MICs were elevated, yet still in the susceptible category, had worse outcomes than similar patients infected with organisms for which MICs were lower. In vitro susceptibility classifications of fluoroquinolones for the treatment of bloodstream infections caused by gram-negative organisms require further study.
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