Indication
Levofloxacin is indicated for the treatment of respiratory tract infections including acute bacterial sinusitis, acute exacerbations of chronic bronchitis, community-acquired pneumonia and nosocomial pneumonia. It is also used in the treatment of uncomplicated and complicated skin & soft tissue infections, chronic bacterial prostatitis and uncomplicated & complicated urinary tract infections (mild to moderate). lt is indicated for the treatment of adults (18 years of age).
Pharmacology
Levofloxacin is a synthetic, broad-spectrum, third generation fluoroquinolone antibiotic. Chemically, Levofloxacin is a chiral fluorinated carboxyquinolone. Levofloxacin exerts antibacterial action by inhibiting bacterial topoisomerase IV and DNA gyrase, the enzymes required for DNA replication, transcription repair and recombination. It has in vitro activity against a wide range of gm-ve and gm+ve microorganisms.
Dosage
Acute sinusitis: 500 mg daily for 10-14 days.Acute exacerbations of chronic bronchitis: 250-500 mg daily for 7-10 days.Community-acquired pneumonia: 500 mg once or twice daily for 7-14 days.Nosocomial pneumonia: 750 mg once daily for 7-14 days.Skin & soft tissue infections: 500 mg once or twice daily for 7-14 days.Chronic prostatitis: 500 mg once daily for 28 days.Urinary tract infections: 250 mg daily for 7-10 days (for 3 days in uncomplicated infections).
Interaction
Antacids, iron and adsorbents reduce absorption of Levofloxacin. NSAIDs may increase the risk of CNS stimulation. Warfarin may increase the risk of bleeding.
Contradiction
Levofloxacin is contraindicated in patients with a history of hypersensitivity to Levofloxacin and other quinolone antimicrobial agents or any other components of this product.
Side Effect
Levofloxacin is generally well tolerated. However, a few side effects can usually be seen. Side effects include nausea, vomiting, diarrhea, abdominal pain, flatulence and rare occurrence of phototoxicity (0.1%). Side effects that may be seen very rarely include- tremors, depression, anxiety, confusion etc.
Pregnancy
US FDA pregnancy category of Levofloxacin is C. So, Levofloxacin should be avoided in pregnancy and lactation unless the potential benefits to the other outweigh the possible risks to the fetus.
Precaution
Adequate amount of water should be taken during treatment period to avoid concentrated form of urine. Dose adjustment is required for patients with impaired renal function.
Overdose
Storage
Keep in a dry place away from light and heat. Keep out of reach of children.