Levofloxacin: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: [[Fluoroquinolone]] | ||
*Dosage Forms: | *Dosage Forms: PO, IV, Inhaled | ||
*Common Trade Names: | *Common Trade Names: Levaquin | ||
==Adult Dosing== | ==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== | ==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== | ==Special Populations== | ||
*Pregnancy: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: Probably Safe | ||
*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== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*[[Myasthenia gravis]] | |||
*[[Long QT]] | |||
*Uncorrected [[electrolyte abnormalities]] | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===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 <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/vomiting]], [[diarrhea]], [[constipation]], [[abdominal pain]] | |||
*[[Headache]] | |||
*[[Insomnia]] | |||
*[[Dizziness]] | |||
*[[Tendinitis]] | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 6-8 h | ||
*Metabolism: | *Metabolism: CYP450 | ||
*Excretion: | *Excretion: Urine | ||
*Mechanism of Action: | *Mechanism of Action: Bactericidal, inhibits DNA gyrase / Topoisomerase IV | ||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ||
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*[[Antibiotics (Main)]] | *[[Antibiotics (Main)]] | ||
== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | |||
[[Category: | [[Category:ID]] |
Latest revision as of 22:53, 22 September 2019
General
- Type: Fluoroquinolone
- 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