Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Adult

500-750mg PO/IV daily

General Information

Common Usage

Lower respiratory infection (CAP, HAP), intraabdominal infection, UTI

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

QTc prolongation

Dysglycemia

CNS toxicity including confusion, psychosis

Tendinopathy and rupture

GI upset

Weakness exacerbation in myasthenia gravis

Rash

Major Interactions

Other QTc prolonging agents

Di- & Trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - decreased absorption

NSAIDs - increase seizure risk

Warfarin - increased INR

Additional Information

FDA Black Box warning against use in uncomplicated UTI, acute bacterial sinusitis, and acute exacerbation of chronic bronchitis where alternatives exist due to serious adverse side effects
May exacerbate muscle weakness in persons with myasthenia gravis. Avoid Use.

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7.0

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic