Levofloxacin

Levofloxacin Brand Names

Iquix | Levaquin | Levaquin Leva-Pak | Quixin

What is Levofloxacin

Levofloxacin is a quinolone antibiotic available for oral, intravenous, or ophthalmic administration.

It is the optically active L-isomer of ofloxacin. Plasma concentrations are similar after intravenous or oral administration and these routes can be considered interchangeable. Unlike ciprofloxacin, levofloxacin does not interact significantly with theophylline. 

Levofloxacin is FDA-approved for the treatment of bacterial conjunctivitis, community-acquired pneumonia (including cases caused by multi-drug-resistant strains of S. pneumoniae), nosocomial pneumonia, skin and skin structure infections, complicated urinary tract infections (UTIs), acute pyelonephritis, chronic bacterial prostatitis, inhalation anthrax (post-exposure), and plague.

Levofloxacin is also FDA-approved for sinusitis, chronic bronchitis, and uncomplicated UTIs; however, due to the potential for serious adverse events, quinolones should only be used for these infection types when alternative treatment options cannot be used.

Disabling and potentially irreversible serious adverse reactions associated with quinolones include tendinitis, tendon rupture, peripheral neuropathy, and central nervous system effects.

Other significant adverse reactions include potential QT prolongation and myasthenia gravis exacerbation.

Indications

  1. Acinetobacter baumannii
  2. Acinetobacter lwoffii
  3. anthrax
  4. anthrax prophylaxis
  5. Bacillus anthracis
  6. bacterial conjunctivitis
  7. bacterial infection prophylaxis
  8. Bordetella pertussis
  9. bronchitis
  10. Campylobacter jejuni
  11. Campylobacter sp.
  12. campylobacteriosis
  13. cellulitis
  14. cervicitis
  15. chlamydia infection
  16. Chlamydophila pneumoniae
  17. Citrobacter freundii
  18. Citrobacter koseri
  19. Clostridium perfringens
  20. community-acquired pneumonia
  21. diabetic foot ulcer
  22. Enterobacter cloacae
  23. Enterobacter sakazakii
  24. Enterococcus faecalis
  25. epididymitis
  26. Escherichia coli
  27. febrile neutropenia
  28. furunculosis
  29. Haemophilus influenzae (beta-lactamase negative)
  30. Haemophilus influenzae (beta-lactamase positive)
  31. Haemophilus parainfluenzae
  32. Helicobacter pylori
  33. Helicobacter pylori (H. pylori) eradication
  34. impetigo
  35. Klebsiella aerogenes
  36. Klebsiella oxytoca
  37. Klebsiella pneumoniae
  38. Legionella pneumophila
  39. Moraxella catarrhalis
  40. Morganella morganii
  41. Mycobacterium avium complex infection
  42. Mycobacterium tuberculosis
  43. Mycoplasma pneumoniae
  44. non-gonococcal urethritis (NGU)
  45. nosocomial pneumonia
  46. Pantoea agglomerans
  47. pelvic inflammatory disease (PID)
  48. plague
  49. plague prophylaxis
  50. pneumonia
  51. prostatitis
  52. Proteus mirabilis
  53. Proteus vulgaris
  54. Providencia rettgeri
  55. Providencia stuartii
  56. Pseudomonas aeruginosa
  57. Pseudomonas fluorescens
  58. pyelonephritis
  59. pyoderma
  60. Salmonella sp.
  61. Salmonella typhi
  62. salmonellosis
  63. sepsis
  64. Serratia marcescens
  65. Shigella dysenteriae
  66. Shigella sp.
  67. shigellosis
  68. sinusitis
  69. skin and skin structure infections
  70. Staphylococcus aureus (MSSA)
  71. Staphylococcus epidermidis
  72. Staphylococcus haemolyticus
  73. Staphylococcus saprophyticus
  74. Streptococcus agalactiae (group B streptococci)
  75. Streptococcus milleri
  76. Streptococcus pneumoniae
  77. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  78. Streptococcus sp.
  79. surgical infection prophylaxis
  80. traveler’s diarrhea
  81. tuberculosis infection
  82. typhoid fever
  83. urethritis
  84. urinary tract infection (UTI)
  85. Viridans streptococci
  86. Yersinia pestis

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agitation
  4. agranulocytosis
  5. anaphylactic shock
  6. anaphylactoid reactions
  7. anemia
  8. angioedema
  9. anorexia
  10. anosmia
  11. anxiety
  12. aortic dissection
  13. aplastic anemia
  14. arthralgia
  15. blurred vision
  16. bronchospasm
  17. candidiasis
  18. cardiac arrest
  19. chest pain (unspecified)
  20. coma
  21. confusion
  22. constipation
  23. crystalluria
  24. cylindruria
  25. delirium
  26. depression
  27. diarrhea
  28. diplopia
  29. dizziness
  30. dysesthesia
  31. dysgeusia
  32. dyspepsia
  33. dysphonia
  34. dyspnea
  35. edema
  36. elevated hepatic enzymes
  37. encephalopathy
  38. eosinophilia
  39. epistaxis
  40. erythema multiforme
  41. esophagitis
  42. fever
  43. foreign body sensation
  44. gastritis
  45. glossitis
  46. hallucinations
  47. headache
  48. headache
  49. hemolytic anemia
  50. hepatic failure
  51. hepatic necrosis
  52. hepatitis
  53. hyperglycemia
  54. hyperkalemia
  55. hyperkinesis
  56. hypertonia
  57. hypoesthesia
  58. hypoglycemia
  59. hypotension
  60. increased intracranial pressure
  61. injection site reaction
  62. insomnia
  63. interstitial nephritis
  64. jaundice
  65. laryngeal edema
  66. leukopenia
  67. memory impairment
  68. musculoskeletal pain
  69. myalgia
  70. myasthenia gravis
  71. nausea
  72. neurotoxicity
  73. nightmares
  74. ocular irritation
  75. ocular pain
  76. ocular pruritus
  77. palpitations
  78. pancreatitis
  79. pancytopenia
  80. paranoia
  81. paresthesias
  82. parosmia
  83. peripheral neuropathy
  84. peripheral vasodilation
  85. pharyngitis
  86. phlebitis
  87. photophobia
  88. photosensitivity
  89. pneumonitis
  90. prolonged bleeding time
  91. pruritus
  92. pseudomembranous colitis
  93. pseudotumor cerebri
  94. psychosis
  95. QT prolongation
  96. rash
  97. renal failure (unspecified)
  98. restlessness
  99. rhabdomyolysis
  100. scotomata
  101. seizures
  102. serum sickness
  103. Stevens-Johnson syndrome
  104. stomatitis
  105. suicidal ideation
  106. syncope
  107. tendinitis
  108. tendon rupture
  109. thrombocytopenia
  110. thrombotic thrombocytopenic purpura (TTP)
  111. tinnitus
  112. torsade de pointes
  113. toxic epidermal necrolysis
  114. tremor
  115. urticaria
  116. uveitis
  117. vaginitis
  118. vasculitis
  119. ventricular tachycardia
  120. vertigo
  121. visual impairment
  122. vomiting
  123. weakness
  124. xerophthalmia

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • aneurysm
  • aortic dissection
  • apheresis
  • arteriosclerosis
  • atrial fibrillation
  • AV block
  • bradycardia
  • breast-feeding
  • cardiac arrhythmias
  • cardiomyopathy
  • celiac disease
  • cerebrovascular disease
  • children
  • colitis
  • contact lenses
  • corticosteroid therapy
  • dehydration
  • depression
  • diabetes mellitus
  • diarrhea
  • driving or operating machinery
  • females
  • fever
  • geriatric
  • GI disease
  • heart failure
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • human immunodeficiency virus (HIV) infection
  • hyperparathyroidism
  • hypertension
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • infants
  • inflammatory bowel disease
  • jaundice
  • laboratory test interference
  • long QT syndrome
  • myasthenia gravis
  • myocardial infarction
  • neonates
  • neurotoxicity
  • organ transplant
  • peripheral neuropathy
  • pheochromocytoma
  • pregnancy
  • pseudomembranous colitis
  • psychiatric event
  • QT prolongation
  • quinolone hypersensitivity
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • seizure disorder
  • sexually transmitted disease
  • sickle cell disease
  • sleep deprivation
  • stroke
  • sunlight (UV) exposure
  • systemic lupus erythematosus (SLE)
  • tendinitis
  • tendinopathy
  • tendon pain
  • tendon rupture
  • torsade de pointes
  • ulcerative colitis

Interactions

  • Abarelix
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