Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

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

750mg IV load then 500mg daily

May increase if larger flow rate

General Information

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

Common Usage

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection

Drug Monitoring

Monitor QTc in patients with increased risk

Major Interactions

  • Other QTc prolonging agents

  • Divalent cations - Decreased absorption

  • NSAIDs - Increase seizure risk

  • Warfarin - Increased INR

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic