Antimicrobials
Levofloxacin (Levaquin)

Levofloxacin (Levaquin)

C difficile risk
High
Oral Bioavailability
Excellent
Cost
IV ~$50.00/day; PO ~$0.90/day

Dosing

500-750mg PO/IV daily

CrCl greater than 50 mL/minCrCl 20-49 mL/minCrCl less than 20 mL/minIntermittent HemodialysisPeritoneal DialysisNo change500mg PO/IV once, then 250mg PO/IV q24h500mg PO/IV once, then 250mg PO/IV q48h500mg IV/PO load then, EITHER 250mg PO/IV q48h OR 125mg PO/IV q24h500mg IV/PO load then, EITHER 250mg PO/IV q48h OR 125mg PO/IV q24h

CrCl greater than 50 mL/minCrCl 20-49 mL/minCrCl less than 20 mL/minIntermittent HemodialysisPeritoneal DialysisNo change750mg PO/IV q48h750mg PO/IV once, then 500mg PO/IV q48h750mg PO/IV load then, EITHER 500mg PO/IV q48h OR 250mg PO/IV q24h750mg PO/IV load then, EITHER 500mg PO/IV q48h OR 250mg PO/IV q24h

General Information

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection

Monitor QTc in patients with increased risk.

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

  • Other QTc prolonging agents

  • Divalent cations - Decreased absorption

  • NSAIDs - Increase seizure risk

  • Warfarin - Increased INR

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 7 hours

Biliary penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic