Levofloxacin Cures Experimental Pneumonic Plague in African Green Monkeys

Levofloxacin Cures Experimental Pneumonic Plague in African Green Monkeys

Robert Colby Layton;William Mega;Jacob D. McDonald;Trevor L. Brasel;Edward B. Barr;Andrew P. Gigliotti;Frederick Koster;
plos neglected tropical diseases 2011 Vol. 5 pp. e959-
299
layton2011ploslevofloxacin

Abstract

Author Summary Yersinia pestis is the causative agent of bubonic plague as well as a rare severe form known as primary pneumonic plague resulting from the inhalation of contaminated aerosols. The relative ease of aerosol preparation and high virulence makes Y. pestis a dangerous bioweapon. The current study describes the treatment of established pneumonic plague with the widely available, broad-spectrum fluoroquinolone antibiotic levofloxacin in a nonhuman primate model. African green monkeys inhaled a target dose of 100 lethal doses for 50% of animals (LD50) and were monitored for fever and vital signs by telemetry. Fever was the first sign of illness, correlating with bacteremia but preceding radiographic pneumonia, and initiated intravenous levofloxacin treatment in doses designed to mimic antibiotic levels achieved in humans. All animals treated with saline died and all animals completing 10 days of treatment survived, with resolution of high fever within 24–48 hours. We conclude that levofloxacin may be an appropriate broad-spectrum antibiotic for presumptive therapy in an aerosolized bioweapons attack and should be studied for treatment of bubonic plague.

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