High-pressure liquid chromatography and microbiological assay of serum ofloxacin levels in adults receiving intravenous and oral therapy for skin infections.

Thirty-two adults hospitalized with skin and skin structure infections received intravenous ofloxacin followed by oral ofloxacin. The standard treatment was 400 mg every 12 h. One patient with renal failure received 400 mg every 24 h. Serum ofloxacin levels were measured (1.5 h postdose and 1 h predose) during intravenous (32 patients) and oral (30 patients) therapy. Levels were assayed by high-pressure liquid chromatography (HPLC) and microbiological assay (MBA). Mean levels +/- standard deviation (in micrograms per milliliter) when measured by MBA after intravenous dosing were (postdose versus predose) 6.23 +/- 2.49 versus 2.42 +/- 1.56, and those after oral dosing were 6.17 +/- 3.25 versus 3.49 +/- 2.77. When measured by HPLC, mean levels +/- standard deviation after intravenous dosing were 5.81 +/- 2.08 versus 2.14 +/- 1.26 and those after oral dosing were 5.63 +/- 2.92 versus 3.41 +/- 2.98. There were no significant differences between levels achieved with oral or intravenous dosing when measured by either MBA or HPLC. Levels in serum did not correlate with side effects. The MICs for 50 and 90% of the 40 aerobic pathogens isolated from 21 patients were 0.5 and 2.0 micrograms/ml, respectively. Cure or improvement was achieved in 30 patients. Intravenous and oral administration of ofloxacin yielded similar levels in serum which were safe and effective in the therapy of skin infections in adult patients.

Haemophilus parainfluenzae as a rare cause of epidural abscess: case report and review.

We report a case of epidural abscess due to Haemophilus parainfluenzae. This microorganism is a normal inhabitant of the upper respiratory tract that causes endocarditis and, rarely, other invasive infections. To the best of our knowledge, epidural abscess due to H. parainfluenzae has not been reported previously. A 74-year-old man presented with neck pain and subsequently developed incomplete quadriparesis. A cervical epidural abscess and vertebral osteomyelitis were detected by radiologic studies. Surgical drainage and antibiotic therapy resulted in resolution of the abscess and osteomyelitis, and the neurologic sequelae were minimal. Cultures of the purulent material from the abscess yielded H. parainfluenzae. Descriptions in the literature of infections caused by H. parainfluenzae and the antimicrobial agents used for treatment of these infections are reviewed.