Class: Fluoroquinolone Antibiotic
Dosage Forms. Oral Solution: 25 mg/mL; Oral Tablet: 250 mg, 500 mg, 750 mg
Common FDA Label Indication, Dosing, and Titration.
1. Bacterial prostatitis, chronic: 500 mg po daily × 28 d
2. Bacterial sinusitis, acute: 750 mg po daily × 5 d
3. Bronchitis, chronic, acute bacterial exacerbation: 500 mg po daily × 7 d
4. Community acquired pneumonia: 500-750 mg po daily × 7-14 d
5. Infection of skin and/or subcutaneous tissue: (uncomplicated) 500 mg po daily × 7-14 d
6. Pyelonephritis, acute: 250 mg po daily × 10 d
1. Chlamydial infection: 500 mg po daily × 7 d
2. Traveler’s diarrhea: 500 mg po daily × 1-3 d
MOA. Levofloxacin is a fluoroquinolone that inhibits bacterial DNA gyrase, an enzyme responsible for the unwinding of DNA for transcription and subsequent supercoiling of DNA for packaging into chromosomal subunits. It is highly active against aerobic, Gram-negative bacilli.
Drug Characteristics: Levofloxacin
Medication Safety Issues: Levofloxacin
Drug Interactions: Levofloxacin
Adverse Reactions: Levofloxacin
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.
Toxicity Monitoring Parameters. Baseline SCr.
Key Patient Counseling Points. Seek medical attention if decreased urination, yellowing of eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath or chest pain, or tendon pain. Take with or without food, but not with milk, yogurt, or other dairy products or calcium-fortified products (some juices and breads). If using antacids, sucralfate, or mineral supplements and multivitamins with calcium, iron, or zinc, take levofloxacin at least 2 h before or 6 h after these medicines.
Clinical Pearls. Not approved in children younger than 18 y of age. Oral and IV dosing is interchangeable. Increased risk of tendon rupture in patients >60 y. Medication guide required at dispensing.