Levofloxacin: Difference between revisions
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==General== | ==General== | ||
*Type: [[ | *Type: [[Is Generation:: 3rd generation]] [[Is DrugClass::Fluoroquinolones]] | ||
*Dosage Forms: | *Dosage Forms: PO, IV, Inhaled | ||
*Common Trade Names: Levaquin | *Common Trade Names: Levaquin | ||
| Line 44: | Line 41: | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
***If usual dose is 750mg qd | |||
****CrCl 20-49: 750mg q48h | |||
****CrCl 10-19: 750mg x1 then 500mg q48h | |||
****CrCl <10: Not defined | |||
****HD/PD: No supplement | |||
***If usual dose is 500mg qd | |||
****CrCl 20-49: 500mg x1, then 250mg q24h | |||
****CrCl 10-19: 500mg x1, then 250mg q48h | |||
****CrCl <10: Not defined | |||
****HD/PD: No supplement | |||
***If usual dose is 250mg qd | |||
****CrCl 10-19: 250mg q48h | |||
****CrCl <10: Not defined | |||
****HD/PD: No supplement | |||
**Pediatric | **Pediatric | ||
* | ***CrCl 10-29: Give q24h | ||
** | ***CrCl <10: Give q48h | ||
** | ***HD/PD: No supplement | ||
*Hepatic Dosing: not defined | |||
==Contraindications== | ==Contraindications== | ||
| Line 57: | Line 69: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Anaphylaxis]] | *[[Anaphylaxis]], hypersensitivity | ||
*Phototoxicity | *Phototoxicity | ||
*[[C. difficile]] diarrhea | *[[C. difficile]] diarrhea | ||
*[[Seizures]] | *[[Seizures]] | ||
*[[Depression]] / | *[[Depression]] / suicidal ideation | ||
*[[Torsades de Pointes]] | *[[Torsades de Pointes]] | ||
*[[Vasculitis]] | *[[Vasculitis]] | ||
*Renal toxicity | *Renal toxicity | ||
*Hepatic toxicity | *Hepatic toxicity | ||
*Tendon rupture/tendinitis (black box warning, inc aged 60+/immunosuppressed/corticosteroid use) | |||
*Myasthenia exacerbation | |||
*Severe Hypoglycemia <ref>FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions. US Food and Drug Administration. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm612995.htm. Updated July 10, 2018. Accessed Oct 22, 2018.</ref> | |||
===Common=== | ===Common=== | ||
*[[Nausea]] | *[[Nausea/vomiting]], [[diarrhea]], [[constipation]], [[abdominal pain]] | ||
*[[Headache]] | *[[Headache]] | ||
*[[Insomnia]] | *[[Insomnia]] | ||
*[[Dizziness]] | *[[Dizziness]] | ||
*[[Tendinitis]] | *[[Tendinitis]] | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 17:05, 18 July 2025
General
- Type: 3rd generation Fluoroquinolones
- Dosage Forms: PO, IV, Inhaled
- Common Trade Names: Levaquin
Adult Dosing
Pneumonia
- Community acquired
- 750mg PO/IV q24h x 5 days
- Nosocomial
- 750 gm PO/IV q24h x 7-14 days
Prostatitis
- 500 MG PO/IV q24h x 28 days
Pyelonephritis
- 750mg PO/IV q24h x 5 days
Skin infection
- Uncomplicated
- 500mg PO/IV q24h x 7-10 days
- Complicated
- 750mg PO/IV q24h x 7-14 days
UTI
- Uncomplicated
- 250mg PO/IV q24h x 3days
- Complicated
- 750mg PO/IV q24h x 5 days
Pediatric Dosing
Pneumonia (Community acquired)
- 6 months - 4 years old
- 16-20mg/kg/day IV or PO, divided q12h x 10 days
- 5-16 years old
- 8-10mg/kg/day IV or PO, divided q12h x 10 days
Special Populations
- Pregnancy Rating: C
- Lactation: Probably Safe
- Renal Dosing
- Adult
- If usual dose is 750mg qd
- CrCl 20-49: 750mg q48h
- CrCl 10-19: 750mg x1 then 500mg q48h
- CrCl <10: Not defined
- HD/PD: No supplement
- If usual dose is 500mg qd
- CrCl 20-49: 500mg x1, then 250mg q24h
- CrCl 10-19: 500mg x1, then 250mg q48h
- CrCl <10: Not defined
- HD/PD: No supplement
- If usual dose is 250mg qd
- CrCl 10-19: 250mg q48h
- CrCl <10: Not defined
- HD/PD: No supplement
- If usual dose is 750mg qd
- Pediatric
- CrCl 10-29: Give q24h
- CrCl <10: Give q48h
- HD/PD: No supplement
- Adult
- Hepatic Dosing: not defined
Contraindications
- Allergy to class/drug
- Myasthenia gravis
- Long QT
- Uncorrected electrolyte abnormalities
Adverse Reactions
Serious
- Anaphylaxis, hypersensitivity
- Phototoxicity
- C. difficile diarrhea
- Seizures
- Depression / suicidal ideation
- Torsades de Pointes
- Vasculitis
- Renal toxicity
- Hepatic toxicity
- Tendon rupture/tendinitis (black box warning, inc aged 60+/immunosuppressed/corticosteroid use)
- Myasthenia exacerbation
- Severe Hypoglycemia [1]
Common
Pharmacology
- Half-life: 6-8 h
- Metabolism: CYP450
- Excretion: Urine
- Mechanism of Action: Bactericidal, inhibits DNA gyrase / Topoisomerase IV
Antibiotic Sensitivities[2]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions. US Food and Drug Administration. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm612995.htm. Updated July 10, 2018. Accessed Oct 22, 2018.
- ↑ Sanford Guide to Antimicrobial Therapy 2014