Levofloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Dosing

500 mg IV/PO every 24 hr

Complicated Infections
750 mg IV/PO every 24 hr

CrCl 50 ml/minCrCl 20-49 ml/minCrCl 10-19 ml/minNo dose adjustment necessaryBased on indication
500 mg x1 then 250 mg IV/PO every 24 hr
OR
750 mg IV/PO every 48 hr500 mg x1 then 250 mg IV/PO every 48 hr
OR
750 mg x1 then 500 mg IV/PO every 48 hr

500 mg x1 then 250 mg IV/PO every 48 hr
OR
750 mg x1 then 500 mg IV/PO every 48 hr

750mg x1 then 500 mg IV/PO every 24 hr

General Information

  • Intraabdominal infection

  • Prostatitis

  • Lower respiratory infection (ICU patients)

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

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.

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection

Lab

  • SCr

  • LFTs with prolonged use

Clinical

  • Hypersensitivity

  • Monitor QTc in patients with increased risk

  • GI effects

  • Drug interactions (warfarin)

  • tendonitis

  • Other QTc prolonging agents

  • Divalent cations - Decreased absorption

  • NSAIDs - Increase seizure risk

  • Warfarin - Increased INR

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic