LEVOFLOXACIN

Fluoroquinolone active against Gram-positive and Gram-negative bacteria; usually reserved for complicated infections

Dosage Forms

Tablet

500 mg

Uses

  • Acute bacterial sinusitis
  • Acute exacerbation of chronic bronchitis
  • Community-acquired pneumonia
  • Pyelonephritis
  • Uncomplicated cystitis
  • Complicated urinary tract infection
  • Chronic bacterial prostatitis
  • Complicated skin and soft tissue infections
  • Inhalation anthrax
  • MDR-TB (specialist use only)

Dose and Duration

Chronic bronchitis, pyelonephritis

Adult above 18 years: 500 mg once daily for 7–10 days

Sinusitis

Adult: 500 mg once daily for 10–14 days

Community acquired pneumonia, complicated urinary tract infection, skin and soft tissue infections

Adult: 500 mg every 12–24 hours for 7–14 days

Uncomplicated cystitis

Adult: 250 mg once daily for 5 days

Chronic bacterial prostatitis

Adult: 500 mg once daily for 28 days

Anthrax

Adult: 500 mg once daily for 8 weeks

Note: In renal impairment, give normal fist dose, then the following dose as shown in the table below
eGFR (ml/minute/1.73 m²) Continuation dose
>50 250 mg/24 h 500 mg/24 h 500 mg/12 h
20–50 125 mg/24 h 250 mg/24 h 250 mg/12 h
10–19 125 mg/48 h 125 mg/24 h 125mg/12h
<10 (also in dialysis) 125 mg/48 h 125 mg/24 h 125 mg/24 h

Contraindications

  • Epilepsy
  • Quinolone hypersensitivity
  • History of tendon disorders related to fluoroquinolones
  • Children and adolescents
  • Pregnancy and breast-feeding

Side Effects

  • Insomnia, headache, dizziness
  • Anaphylactic shock
  • Diarrhoea, vomiting, nausea
  • Increased liver enzymes (ALT and AST)
  • Stevens-Johnson syndrome

Interactions

  • Ciclosporin (increased risk of nephrotoxicity)
  • Artemether + lumefantrine (risk of irregular heart beat)

Patient Instructions

  • Do not drive or operate machinery if medicine makes you drowsy

Pregnancy

  • Do not use

Breast-feeding

  • Do not use

⚠️ Caution

  • Do not use for suspected or known Methicillin Resistant Staphylococcus aureus due to likelihood of co-resistance
  • Tendinitis and tendon rapture may occur from 48 hours up to several months after discontinuation. Risk is higher in patients over 60 years. Stop treatment if it occurs
  • Use with caution in history of epilepsy, conditions predisposed to seizures, G6PD deficiency, myasthenia gravis
  • Discontinue treatment if psychiatric, neurological or hypersensitivity reactions occur