Levofloxacin

제한된
0
C. difficile 위험도
High
경구생체이용률
Excellent

Dosing

750 mg PO q24h

Safety and efficacy in pediatric patients <18y of age have not been established

No dose adjustment

CrCl >50CrCl 10-50CrCl <10HDCRRTNo dose adjustment750 mg PO q24-48h250 mg PO q48h(a) when normal dose is 750 mg q24h : 750 mg once, then 500 mg q48h (b) when normal dose is 500 mg q24h : 500 mg once, then 250 mg q48h

TB : 750-1,000 mg PO/IV 3 times/week750 mg once, then 500 mg q48h

General Information

  • Lower respiratory infection (CAP, HAP)

  • Intraabdominal infection

Black Box Warning:

  • Discontinue levofloxacin and avoid use of fluoroquinolones in patients with these serious adverse reactions.

  • Reserve use of levofloxacin for patients with no alternative treatment options for an uncomplicated UTI, acute bacterial exacerbation of chronic bronchitis, or acute bacterial sinusitis.

  • Avoid in patients with known history of myasthenia gravis.

Monitor QTc in patients with increased risk.

Monitor WBC counts and follow culture and susceptibility tests during treatment.

Obtain acid-fast bacilli (AFB) smear and culture from sputum at least monthly until 2 consecutive culture specimens are negative.

Monitor CBC with differential, renal and liver function tests, blood glucose, and serum electrolytes.

Common

  • Diarrhea

  • Nausea

  • Dizziness

  • Headache

  • Insomnia

Serious

  • Aortic aneurysm

  • Cardiac arrest

  • Prolonged QT interval

  • Trosades de pointes

  • Ventricular tachycardia

  • Erythema multiforme

  • Stevens-Johnson syndrome

  • Hypoglycemia

  • Aplastic anemia

  • Pancytopenia

  • Thrombocytopenic purpura

  • Hepatitis

  • Hypersensitivity reaction

  • Myasthenia gravis

  • Rupture of tendon

  • Tendinitis

  • Retinal detachment

  • Neurologic effects

  • Psychiatric effects

  • Acute renal failure

  • Tubulointerstitial nephritis

  • 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

Urine penetration: Therapeutic

Lung penetration: Therapeutic

Biliary penetration: Therapeutic

Precautions:

  • Avoid use with known QT prolongation, uncorrected hypokalemia, and with Class IA or Class III antiarrhythmic agents.

  • Avoid use patients at risk for developing aortic aneurysm (unless alternative treatment is unavailable) and discontinue treatment if aortic aneurysm or dissection is suspected or occurs.

  • Discontinue of signs and symptoms of hepatitis, hypersensitivity reactions, psychiatric reactions or CNS adverse reactions occur.

  • Use caution in patients with renal dysfunction or renal failure due to risk of seizures and tendon rupture.

Micromedex web. Greenwood Village (CO): Truven Health Analytics; 2019 [cited 2019 October 15]. Available from: Micromedex

Terms of Use | Feedback
© Copyright 2021 Spectrum Mobile Health Inc., dba Firstline Clinical. All rights reserved.