Levofloxacin

C difficile risk
High
Oral Bioavailability
Excellent (90 to 100%)
Cost
$0.30 (PO) $81.87 (IV)

Dosing

500-750mg PO/IV daily

eGFR 0 - 20eGFR 20 - 50eGFR > 50750mg once then 500mg PO/IV q48h750mg PO/IV q48h750mg PO/IV daily

750mg IV/PO load then 500mg q48h

Supplemental doses not required after HD

750mg IV/PO Load then 500-750mg PO/IV q24-48h

Varies according to type of renal replacement therapy

Pharmacist consult recommended

General Information

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection (with metronidazole)

Monitor QTc in patients with increased risk

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

  • Other QTc prolonging agents

  • Divalent cations - Decreased absorption

  • NSAIDs - Increase seizure risk

  • Warfarin - Increased INR

IV Administration
Premixed bags; infusion time 250 mg (30 min), 500 mg (60 min), 750 mg (90 min)

EH Prescribing Restrictions
None (Pharmacist reviews IV therapy)

NLPDP Status (PO)
Special Authorization required

Community IV Formulary (Metro Area)
NO. Premixed bags are not compatible with pumps used by community IV program

Special Authorization Required

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic