Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

IV-$14/d PO-$3/d

Dosing

General Pediatric

8-10 mg/kg/dose IV/PO q12h
6 Months - 5 Years

8-10 mg/kg/dose IV/PO q24h
Maximum: 750 mg/dose
5 + Years

Adult

500-750 mg IV/PO q24h

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  • Dizziness

  • Insomnia

  • Rash

  • Nausea & Vomiting

  • Abdominal pain

  • Tendinopathy and rupture have been reported

  • QTc prolongation have been reported

Major Interactions

  • Increased risk when combined with other QTc prolonging agents.

  • AVOID concomitant administration with antacids, multivitamin & mineral supplements. Space doses by 2 hours.

  • Increased risk of tendon rupture especially with concomitant use of corticosteroids.

  • Monitor INR with warfarin.

Additional Information

Dosing for oral and IV levofloxacin is identical
Not to be given IM or SC administration.

Pharmacology

Antimicrobial class: Fluoroquinolone

Route of Elimination: 87% excreted unchanged in urine over 48 hours by tubular secretion and glomerular filtration; 4% in feces

Average serum half life:

  • Infants ≥6 months to 5 years: ~4 hours.

  • Children 5-16 years: 4.8-6 hours.

  • Adults: 6-8 hours