Levaquin (levofloxacin) is a broad-spectrum fluoroquinolone antibiotic indicated for the treatment of adults with serious bacterial infections. It demonstrates excellent tissue penetration and bactericidal activity against a wide range of Gram-positive and Gram-negative pathogens. This medication is reserved for cases where first-line antibiotics have failed or are inappropriate due to resistance patterns or patient factors. Proper diagnosis and antimicrobial stewardship are essential when considering Levaquin therapy.

Features

• Active ingredient: Levofloxacin
• Available in 250mg, 500mg, and 750mg tablets
• Available as intravenous injection solution
• Broad-spectrum activity against aerobic Gram-positive and Gram-negative bacteria
• Once-daily dosing regimen
• Rapid absorption with high oral bioavailability (~99%)

Benefits

• Effective against multidrug-resistant pathogens including Pseudomonas aeruginosa
• Excellent penetration into lung tissue, prostate, and other difficult-to-treat sites
• Convenient once-daily dosing improves patient compliance
• Demonstrated efficacy in complicated urinary tract infections and community-acquired pneumonia
• Suitable for sequential therapy (IV to oral conversion)
• Coverage includes atypical pathogens like Legionella and Chlamydia species

Common use

Levaquin is prescribed for the treatment of adults with:

• Community-acquired pneumonia
• Complicated skin and skin structure infections
• Complicated urinary tract infections
• Acute pyelonephritis
• Chronic bacterial prostatitis
• Inhalational anthrax (post-exposure)
• Plague
• Acute bacterial sinusitis
• Acute bacterial exacerbation of chronic bronchitis

Dosage and direction

Dosage varies based on infection type and severity:

• Community-acquired pneumonia: 750mg once daily for 5 days
• Complicated skin infections: 750mg once daily for 7-14 days
• Complicated UTI/pyelonephritis: 750mg once daily for 5 days
• Chronic bacterial prostatitis: 500mg once daily for 28 days

Take tablets with a full glass of water, with or without food. Maintain adequate hydration during treatment. Complete the full course of therapy even if symptoms improve earlier. Do not crush or chew tablets.

Precautions

• Tendon inflammation and rupture may occur, especially in patients over 60, those taking corticosteroids, or organ transplant recipients
• May exacerbate muscle weakness in patients with myasthenia gravis
• Peripheral neuropathy may occur and can be permanent
• CNS effects including seizures, increased intracranial pressure, and psychosis
• Photosensitivity reactions: avoid excessive sunlight and artificial UV light
• Clostridium difficile-associated diarrhea may occur
• Not recommended for uncomplicated infections when other alternatives exist

Contraindications

• Known hypersensitivity to levofloxacin or other quinolones
• History of tendon disorders related to fluoroquinolone use
• Patients with myasthenia gravis
• Concurrent administration with tizanidine
• Pediatric patients (except for inhalational anthrax)
• Pregnancy and breastfeeding (unless potential benefit justifies risk)

Possible side effect

Common (≥1%):

• Nausea
• Diarrhea
• Headache
• Constipation
• Insomnia

Serious (seek immediate medical attention):

• Tendon pain, swelling, or rupture
• Peripheral neuropathy (pain, burning, tingling)
• CNS effects (seizures, hallucinations, depression)
• Hypersensitivity reactions
• Hepatotoxicity
• QT prolongation and arrhythmias
• Blood glucose disturbances

Drug interaction

• Antacids containing magnesium/aluminum, sucralfate, metal cations: separate by至少 2 hours
• Warfarin: increased anticoagulant effect
• NSAIDs: increased seizure risk
• Corticosteroids: increased tendon rupture risk
• Antiarrhythmics (Class IA, III): increased QT prolongation risk
• Theophylline: increased theophylline levels
• Oral hypoglycemics: may affect glucose control
• Cyclosporine: increased creatinine levels

Missed dose

Take the missed dose as soon as remembered, unless it’s almost time for the next dose. Do not double the dose to make up for a missed one. Maintain regular dosing intervals to ensure consistent antibiotic levels.

Overdose

Symptoms may include CNS excitation, seizures, nausea, and prolongation of the QT interval. Management is supportive with ECG monitoring. Hemodialysis removes approximately 10% of the dose. There is no specific antidote.

Storage

Store at room temperature (15-30°C/59-86°F) in original container. Keep tightly closed and protect from light and moisture. Do not store in bathroom. Keep out of reach of children and pets. Do not use after expiration date.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Levaquin is available by prescription only and should be used under appropriate medical supervision. Healthcare providers should assess risks and benefits for each patient. Always follow your healthcare provider’s instructions and report any adverse effects immediately.

Reviews

“Levaquin has been invaluable in our ICU for treating multidrug-resistant pneumonias. The once-daily dosing simplifies our antimicrobial regimen.” - Infectious Disease Specialist, 15 years experience

“While effective, we reserve levofloxacin for cases where narrower spectrum agents have failed due to the risk of adverse effects and concern for resistance development.” - Hospital Pharmacist

“Patient response has been generally positive for complicated UTIs, though we monitor carefully for tendon and neurological side effects, particularly in elderly patients.” - Urology Department