Assessment of Antibacterial Activity of Levonadifloxacin against Contemporary Gram-positive Clinical Isolates Collected from Various Indian Hospitals using Disk-Diffusion Assay

• Published in: Indian journal of medical microbiology 2020-07, Vol.38 (3), p.307-312
• Main Authors: Baliga, Shrikala, Mamtora, Dhruv K, Gupta, Varsha, Shanmugam, Priyadarshini, Biswas, Sanjay, Mukherjee, D.N, Shenoy, Suchitra
• Format: Article
• Language: English
• Subjects: Antibacterial activity; Antibiotic resistance; Bacteremia; Clinical isolates; Diabetes mellitus; Diffusion; Diffusion rate; Disks; Drug resistance; Gram-positives; Hospitals; Infections; Infectious Disease; levonadifloxacin; Methicillin; methicillin-resistant Staphylococcus aureus; Monte Carlo simulation; Pathogens; Penicillin; Pharmacodynamics; Pharmacokinetics; Pharmacology; quinolone-resistant Staphylococcus aureus; Skin; Staphylococcus infections; susceptibility testing; Vancomycin
• ISSN: 0255-0857; 1998-3646
• DOI: 10.4103/ijmm.IJMM_20_307

Objectives: Levonadifloxacin is a novel benzoquinolizine subclass of quinolone with broad-spectrum activities against problematic pathogens such as methicillin-resistant Staphylococcus aureus, quinolone-resistant S. aureus, vancomycin intermediate S. aureus, and vancomycin-resistant S. aureus. Levonadifloxacin and its oral prodrug, alalevonadifloxacin, have been recently approved in India for the treatment of acute bacterial skin and skin structure infections, including concurrent bacteraemia and diabetic foot infections. The aim of the study is to assess the activity of levonadifloxacin against Gram-positive clinical isolates collected from various Indian hospitals using the disc-diffusion method. Materials and Methods: Nonduplicate isolates of S. aureus and other Gram-positive isolates collected from June 2019 to March 2020 were subjected to levonadifloxacin susceptibility testing (disk diffusion method) as per the Clinical and Laboratory Standards Institute guidelines (Year 2019). Levonadifloxacin 10 μg impregnated disks were used during the testing. Results: A total of 664 diverse Gram-positive clinical isolates collected from six different hospitals in India were analyzed. Majority (65.5%) of the isolates were S. aureus. All the S. aureus and other Gram-positive isolates were found to be susceptible to levonadifloxacin as per the prespecified interpretive criteria identified based on population pharmacokinetic model and Monte Carlo simulation enabled probability of pharmacodynamic target attainment analysis. Conclusions: The present study showed that levonadifloxacin was highly active against contemporary Gram-positive pathogens and furthermore demonstrated that levonadifloxacin susceptibilities can be reliably determined using the disc-diffusion method.