Diferencia entre revisiones de «Levofloxacin»

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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:  
*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
*Hepatic Dosing
***CrCl 10-29: Give q24h
**Adult
***CrCl <10: Give q48h
**Pediatric
***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>==
{| class="wikitable"
| align="center" style="background:#f0f0f0;"|'''Group'''
| align="center" style="background:#f0f0f0;"|'''Organism'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||'''S'''
|-
| ||[[Enterococcus faecalis]]||'''S'''
|-
| ||[[Enterococcus faecium]]||R
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||I
|-
| ||[[Staph. Epidermidis]]||'''S'''
|-
| ||[[C. jeikeium]]||X1
|-
| ||[[L. monocytogenes]]||'''S'''
|-
| Gram Negatives||[[N. gonorrhoeae]]||I
|-
| ||[[N. meningitidis]]||'''S'''
|-
| ||[[Moraxella catarrhalis]]||'''S'''
|-
| ||[[H. influenzae]]||'''S'''
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||'''S'''
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||'''S'''
|-
| ||[[Enterobacter]] sp, AmpC pos||'''S'''
|-
| ||[[Serratia]] sp||'''S'''
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||'''S'''
|-
| ||[[Shigella]] sp||'''S'''
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||'''S'''
|-
| ||[[Providencia sp.]]||'''S'''
|-
| ||[[Morganella sp.]]||'''S'''
|-
| ||[[Citrobacter freundii]]||'''S'''
|-
| ||[[Citrobacter diversus]]||'''S'''
|-
| ||[[Citrobacter sp.]]||'''S'''
|-
| ||[[Aeromonas sp]]||'''S'''
|-
| ||[[Acinetobacter sp.]]||I
|-
| ||[[Pseudomonas aeruginosa]]||I
|-
| ||[[Burkholderia cepacia]]||X1
|-
| ||[[Stenotrophomonas maltophilia]]||I
|-
| ||[[Yersinia enterocolitica]]||'''S'''
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||'''S'''
|-
| ||[[Pasteurella multocida]]||'''S'''
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||'''S'''
|-
| ||[[Mycoplasm pneumoniae]]||'''S'''
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||'''S'''
|-
| ||[[Clostridium difficile]]||R
|-
| ||[[Clostridium (not difficile)]]||'''S'''
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}
 
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Antibiotics (Main)]]


==Source==
==References==
<references/>


<references/>
[[Category:Pharmacology]]
[[Category:Drugs]]
[[Category:ID]]

Revisión actual - 17:05 18 jul 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
    • Pediatric
      • CrCl 10-29: Give q24h
      • CrCl <10: Give q48h
      • HD/PD: No supplement
  • Hepatic Dosing: not defined

Contraindications

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 6-8 h
  • Metabolism: CYP450
  • Excretion: Urine
  • Mechanism of Action: Bactericidal, inhibits DNA gyrase / Topoisomerase IV

Antibiotic Sensitivities[2]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium R
MSSA S
MRSA R
CA-MRSA I
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ S
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii S
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa I
Burkholderia cepacia X1
Stenotrophomonas maltophilia I
Yersinia enterocolitica S
Francisella tularensis X1
Brucella sp. X1
Legionella sp. S
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica S
Clostridium difficile R
Clostridium (not difficile) S
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

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

  1. ↑ 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.
  2. ↑ Sanford Guide to Antimicrobial Therapy 2014
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