Levoquin: Advanced Antibiotic Therapy for Severe Bacterial Infections
Levoquin
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| Product dosage: 500mg | |||
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Levoquin (levofloxacin) is a potent fluoroquinolone antibiotic designed to combat a wide spectrum of serious bacterial infections. With its broad-spectrum bactericidal activity and excellent tissue penetration, Levoquin represents a critical therapeutic option for healthcare providers treating complex infections where first-line antibiotics have failed or are inappropriate. Its once-daily dosing regimen supports patient compliance while delivering consistent therapeutic concentrations at infection sites. This medication is reserved for cases where the benefit-risk profile justifies its use, following appropriate diagnostic procedures and susceptibility testing.
Features
- Contains levofloxacin, a third-generation fluoroquinolone antibiotic
- Available in oral tablets (250 mg, 500 mg, 750 mg) and intravenous formulations
- Bactericidal action through inhibition of bacterial DNA gyrase and topoisomerase IV
- Broad-spectrum activity against Gram-positive, Gram-negative, and atypical pathogens
- Excellent bioavailability and tissue penetration (lung, prostate, skin, urine)
- Once-daily dosing convenience
Benefits
- Effectively treats multidrug-resistant bacterial infections when other antibiotics fail
- Rapid bactericidal action reduces bacterial load and accelerates clinical improvement
- Comprehensive coverage of common and atypical respiratory pathogens
- High success rates in complicated urinary tract and skin structure infections
- Convenient dosing schedule improves adherence to treatment regimens
- Well-established safety profile with extensive clinical experience
Common use
Levoquin is indicated for treatment of adults with:
- Community-acquired pneumonia (including multidrug-resistant Streptococcus pneumoniae)
- Complicated urinary tract infections, including pyelonephritis
- Acute bacterial exacerbation of chronic bronchitis
- Complicated skin and skin structure infections
- Acute bacterial sinusitis
- Inhalational anthrax (post-exposure)
- Plague
Dosage and direction
Standard dosage: 500 mg once daily (250 mg once daily for uncomplicated UTIs) Duration: 7-14 days depending on infection type and severity (minimum 48 hours after symptoms resolve) Administration:
- Oral tablets: Take with full glass of water, with or without food
- IV infusion: Administer over 60 minutes for 250 mg/500 mg doses, 90 minutes for 750 mg doses
- Maintain adequate hydration during treatment
- Complete full course of therapy even if symptoms improve earlier
Dosage adjustment required for renal impairment (CrCl <50 mL/min):
- CrCl 20-49 mL/min: Initial 500 mg, then 250 mg every 24 hours
- CrCl 10-19 mL/min: Initial 500 mg, then 250 mg every 48 hours
Precautions
- Reserve use for infections proven or strongly suspected to be caused by susceptible bacteria
- Monitor for tendon inflammation or rupture (may occur during or after therapy)
- Assess cardiac rhythm in patients with known QT prolongation, uncorrected hypokalemia, or taking concurrent QT-prolonging drugs
- Use with caution in patients with CNS disorders (seizures, epilepsy) or risk factors for seizures
- Avoid excessive sunlight/UV exposure due to photosensitivity risk
- Monitor blood glucose regularly in diabetic patients (may cause hypoglycemia/hyperglycemia)
- Not recommended for uncomplicated infections when other alternatives are available
Contraindications
- Known hypersensitivity to levofloxacin, other quinolones, or product components
- History of tendon disorders related to fluoroquinolone administration
- Concurrent administration with tizanidine
- Pediatric patients (except for inhalational anthrax)
- Pregnancy and breastfeeding (unless potential benefit justifies potential risk)
Possible side effect
Common (≥1%):
- Nausea (6.5%)
- Diarrhea (5.3%)
- Headache (5.9%)
- Constipation (3.3%)
- Dizziness (2.8%)
- Insomnia (3.8%)
Serious (<1% but require immediate medical attention):
- Tendon rupture (Achilles, hand, shoulder)
- Peripheral neuropathy (may be irreversible)
- CNS effects (seizures, psychosis, increased intracranial pressure)
- QT prolongation and torsades de pointes
- Hypersensitivity reactions (anaphylaxis, Stevens-Johnson syndrome)
- Hepatotoxicity (elevated transaminases, hepatitis)
- Clostridium difficile-associated diarrhea
- Blood glucose disturbances
Drug interaction
- Antacids, sucralfate, metal cations (iron, zinc, calcium, magnesium): Reduce absorption (administer 2 hours before or 4 hours after levofloxacin)
- Warfarin: Enhanced anticoagulant effect (monitor INR closely)
- NSAIDs: Increased risk of CNS stimulation and seizures
- QT-prolonging drugs (antiarrhythmics, antipsychotics, macrolides): Additive QT prolongation risk
- Oral hypoglycemics: Altered glucose control
- Corticosteroids: Increased risk of tendon rupture
Missed dose
Take the missed dose as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Maintain regular dosing intervals to ensure consistent antibiotic levels.
Overdose
Symptoms may include CNS excitation (seizures, confusion), QT prolongation, and gastrointestinal distress. Management is supportive with ECG monitoring. Levofloxacin is not effectively removed by hemodialysis or peritoneal dialysis. Maintain adequate hydration and administer anticonvulsants if needed.
Storage
- Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)
- Keep container tightly closed
- Protect from light and moisture
- Keep out of reach of children
- Do not use after expiration date
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Levoquin is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The prescribing physician should review complete prescribing information and consider individual patient factors before initiation. Patients should report any adverse effects to their healthcare provider immediately.
Reviews
“Levoquin has been invaluable in our ICU for treating multidrug-resistant Pseudomonas infections. The once-daily dosing simplifies administration in critically ill patients.” - Infectious Disease Specialist, 15 years experience
“While effective, we reserve levoquin for cases where narrower-spectrum options are inappropriate due to the black box warnings. Appropriate patient selection is crucial.” - Hospital Pharmacist
“Patient response has been generally positive for complicated UTIs, though we monitor closely for tendon and neuropathic side effects, especially in elderly patients.” - Urology Department