GLOBAL Surveillance

Large-scale surveillance initiatives, GLOBAL (Global Landscape On Bactericidal Activities of Levofloxacin) Surveillance, provide a current perspective on antimicrobial susceptibility on a worldwide scale and identify new trends in resistance as they emerge.

Gram-negative pathogens 2003:
Levofloxacin is marketed not only for respiratory tract infections but also for the treatment of uncomplicated urinary tract infections (UTI), complicated UTIs (including pyelonephritis), and skin and soft tissue infections.

Increases in antimicrobial resistance among Gram-negative pathogens predominant in these infections sites have been widely reported in recent years.

To benchmark the in vitro activity of levofloxacin against recent clinical isolates from these sites of infection, the GLOBAL Surveillance study examined the in vitro susceptibility of 2,926 Enterobacteriaceae and non-Enterobacteriaceae isolated from patient specimens at hospital laboratories in Belgium, France, Germany, Italy, and Spain during 2003. Isolates were centrally tested (Focus Technologies, Inc., Herndon, Virginia USA) by broth microdilution according to NCCLS defined methodology (M7-A6, 2003) against levofloxacin, sitafloxacin, ciprofloxacin, gatifloxacin, ampicillin, amoxicillin-clavulanate, cefotaxime, ceftazidime, ceftriaxone, imipenem, gentamicin, and trimethoprim-sulfamethoxazole (TMP-SMX).

MICs were interpreted as susceptible, intermediate, or resistant according to the NCCLS published breakpoints (M100-S13, 2003), where available. Extended spectrum β-lactamase (ESBL) testing was performed for all Escherichia coli and Klebsiella pneumoniae isolates with MICs to cefotaxime and/or ceftazidime ≥4 µg/ml.