In vitro activity of levofloxacin and FK-037 against aerobic isolates from spontaneous bacterial peritonitis

Spontaneous bacterial peritonitis is a potentially fatal complication of ascites, most often caused by the Enterobacteriaceae or streptococci. We have evaluated the in vitro activity of FK-037, a new cephalosporin, cefotaxime, cefpirome, ceftazidime, levofloxacin, and ofloxacin against a collection of 124 isolates from patients with spontaneous bacterial peritonitis. Levofloxacin (≤ 2 mg/L) was active against all isolates and ofloxacin (≤ 2 mg/L) against 98.4% of isolates. The cephalosporins (≤ 8 mg/L) were less active against cefpi- rome =95.4%, FK-037 =94.4%, and cefotaxime and ceftazidime =91.1%. Given the high mortality associated with spontaneous bacterial peritonitis, clinical studies of the quinolones (specifically of levofloxacin) and the alter-native cephalosporins presented for treatment of spontaneous bacterial peritonitis appears warranted.