Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

Dosing

Adult

500 mg IV/PO every 24 hr

Complicated Infections
750 mg IV/PO every 24 hr

General Information

Acceptable Uses

  • Intraabdominal infection

  • Prostatitis

  • Lower respiratory infection (ICU patients)

Unacceptable Uses

Empiric therapy

  • UTI/Pyelonephritis

  • Bronchitis

  • CAP and COPD exacerbation (NON-ICU patients)

Note: per BMH policy Levaquin will be automatically interchanged for the above indications

Common Usage

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection

Drug Monitoring

Lab

  • SCr

  • LFTs with prolonged use

Clinical

  • Hypersensitivity

  • Monitor QTc in patients with increased risk

  • GI effects

  • Drug interactions (warfarin)

  • tendonitis

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

Major Interactions

  • Other QTc prolonging agents

  • Divalent cations - Decreased absorption

  • NSAIDs - Increase seizure risk

  • Warfarin - Increased INR

Additional Information

Fluoroquinolones are associated with disabling and potentially irreversible serious adverse reactions that may occur together, including tendinitis and tendon rupture, peripheral neuropathy, and CNS effects. Discontinue levofloxacin immediately and avoid use of fluoroquinolones in patients who experience any of these serious adverse reactions.

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7 hours

Biliary penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic