A prospective study of ofloxacin in acute exacerbations of chronic respiratory disease associated with Pseudomonas aeruginosa.

Forty patients (32 inpatients and 8 outpatients) with acute purulent exacerbations of obstructive respiratory disease associated with Pseudomonas aeruginosa were treated orally with 800 mg ofloxacin twice daily for seven days. Sputum was cultured before, during and after treatment. The drug was extremely well tolerated, only one patient discontinuing because of alleged nausea. The infection was completely eradicated, with excellent clinical results and negative sputum cultures, in 23 patients. In six others the Ps. aeruginosa infection was cleared although reinfection with different organisms followed. Five patients showed recurrence of the infection after apparent initial eradication, but Ps. aeruginosa persisted in three others. Three patients were not evaluable because of death, transfer elsewhere, or discontinuation. There was a slight tendency for the mean MICs to rise during treatment, owing to eradication of all highly sensitive strains. Resistance did not develop. These results suggest that purulent exacerbations of chronic respiratory disease caused by Ps. aeruginosa can safely be treated orally with 800 mg ofloxacin twice daily, but that further studies in outpatients should be performed.