Levofloxacin

Fluoroquinolone Antibiotic

Generic Name

Levofloxacin

Drug Class

Fluoroquinolone antibiotic

Indications

Respiratory tract infections (pneumonia, bronchitis, sinusitis)
Urinary tract infections, pyelonephritis
Skin and soft tissue infections
Prostatitis
Anthrax (inhalational)

Dosage

Adults: 250–750 mg orally or IV once daily depending on infection type and severity
Elderly: Use caution; dose adjustment may be needed in renal impairment

Note: Dose adjustment is required in moderate to severe renal impairment.

Route of Administration

Oral (tablet, solution), Intravenous (IV)

Mechanism of Action

Levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, enzymes required for DNA replication, transcription, repair, and recombination, leading to bacterial death.

Common Adverse Effects

Nausea, vomiting
Diarrhea
Headache, dizziness
Insomnia

Serious Adverse Effects

Tendinitis and tendon rupture (especially Achilles tendon)
Peripheral neuropathy
QT prolongation and arrhythmias
Hypersensitivity reactions
Hepatotoxicity (rare)

Contraindications

Hypersensitivity to levofloxacin or other fluoroquinolones
History of tendon disorders related to fluoroquinolone use
Concomitant use of tizanidine

Precautions

Use caution in elderly and patients with renal impairment
Avoid excessive sun exposure due to photosensitivity
Monitor for signs of neuropathy or tendon pain
Patients with cardiac disorders should be monitored for QT prolongation

Drug Interactions

Antacids, iron, calcium, magnesium – reduce absorption
Warfarin – may increase anticoagulant effect
Antiarrhythmics – additive risk of QT prolongation

Pregnancy & Lactation

Use only if benefits outweigh risks; safety in pregnancy and breastfeeding is not well established.

Patient Counseling

Take on an empty stomach or 2 hours before/after meals containing dairy or minerals
Report tendon pain, swelling, or neuropathic symptoms immediately
Avoid excessive sun exposure; use sunscreen
Complete the full course of therapy