항생제
Levofloxacin

Levofloxacin

High
Excellent

Spectrum Of Activity

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