Levaquin (levofloxacin) is a broad-spectrum fluoroquinolone antibiotic indicated for the treatment of adults with serious bacterial infections. It demonstrates excellent tissue penetration and bactericidal activity against a wide range of Gram-positive and Gram-negative pathogens, including some multidrug-resistant strains. This medication is reserved for cases where other antibiotics have failed or are inappropriate due to resistance patterns or allergy concerns. Proper patient selection and adherence to prescribing guidelines are essential to maximize therapeutic benefits while minimizing risks.

Features

• Contains levofloxacin, the L-isomer of ofloxacin with enhanced antibacterial activity
• Available in oral tablets (250mg, 500mg, 750mg) and intravenous solution
• Broad-spectrum coverage including Pseudomonas aeruginosa and methicillin-susceptible Staphylococcus aureus
• Once-daily dosing regimen for most indications
• Excellent bioavailability with oral administration (approximately 99%)
• Penetrates well into tissues including lungs, skin, and prostate

Benefits

• Effective against difficult-to-treat and multidrug-resistant bacterial infections
• Rapid bactericidal action helps control infection progression quickly
• Convenient once-daily dosing improves patient compliance
• Both oral and IV formulations allow for seamless transition from hospital to outpatient care
• Proven efficacy in complicated urinary tract, respiratory, and skin structure infections
• Comprehensive coverage reduces the need for combination antibiotic therapy in many cases

Common use

Levaquin is indicated for the treatment of adults with the following bacterial infections: complicated urinary tract infections including pyelonephritis; complicated skin and skin structure infections; community-acquired pneumonia of mild to moderate severity; acute bacterial sinusitis; acute bacterial exacerbation of chronic bronchitis; and inhalational anthrax exposure. It may also be used for nosocomial pneumonia when appropriate pathogens are suspected. Healthcare providers should reserve Levaquin for these specific indications due to the risk of serious adverse reactions.

Dosage and direction

Dosage varies by indication and renal function. For most infections in patients with normal renal function (creatinine clearance ≥50 mL/min): 250-750 mg orally or IV once daily. Duration typically ranges from 7-14 days depending on infection severity and clinical response. For complicated urinary tract infections or acute pyelonephritis: 250 mg daily for 10 days. For community-acquired pneumonia: 500 mg daily for 7-14 days. For complicated skin and skin structure infections: 750 mg daily for 7-14 days. Dosage adjustment is required for patients with renal impairment. Administer tablets with water, with or without food, at approximately the same time each day. Complete the full prescribed course even if symptoms improve earlier.

Precautions

Levaquin carries several important precautions. Tendon inflammation and rupture may occur during or after therapy, particularly in elderly patients, those taking corticosteroids, and organ transplant recipients. Discontinue immediately if tendon pain, swelling, or inflammation occurs. Peripheral neuropathy may occur rapidly and potentially become permanent. Monitor for symptoms of numbness, tingling, or weakness. Central nervous system effects including seizures, increased intracranial pressure, and psychiatric reactions have been reported. Use with caution in patients with known or suspected CNS disorders. Levaquin may exacerbate muscle weakness in persons with myasthenia gravis. Photosensitivity reactions may occur; advise patients to avoid excessive sunlight and artificial UV exposure. Blood glucose disturbances may occur, especially in diabetic patients; monitor blood glucose closely.

Contraindications

Levaquin is contraindicated in patients with known hypersensitivity to levofloxacin, other quinolone antibiotics, or any component of the formulation. It is contraindicated in patients with a history of tendon disorders related to fluoroquinolone use. Concurrent administration with tizanidine is contraindicated due to potentially dangerous drug interactions. Levaquin should not be used in pediatric patients, adolescents, pregnant women, or nursing mothers except for post-exposure inhalational anthrax treatment due to arthropathy effects observed in juvenile animals.

Possible side effect

Common side effects (≥1%) include nausea, diarrhea, headache, constipation, insomnia, dizziness, and abdominal pain. Serious side effects requiring immediate medical attention include tendon rupture, peripheral neuropathy, CNS effects (seizures, increased intracranial pressure, psychosis), QT prolongation and arrhythmias, hypersensitivity reactions, hepatotoxicity, blood disorders, and Clostridium difficile-associated diarrhea. Musculoskeletal side effects may include arthralgia, myalgia, and gait disturbance. Ophthalmologic effects including vision disturbance have been reported. Renal toxicity may occur, particularly in dehydrated patients or those receiving concurrent nephrotoxic drugs.

Drug interaction

Levaquin has several significant drug interactions. Antacids containing magnesium or aluminum, sucralfate, metal cations such as iron, and multivitamins containing zinc may significantly reduce absorption; separate administration by at least 2 hours. NSAIDs may increase the risk of CNS stimulation and seizures. Levaquin may enhance the effects of warfarin; monitor INR closely. QT prolongation may be additive with other drugs that prolong QT interval including antiarrhythmics, antipsychotics, antidepressants, and certain antibiotics. Corticosteroids may increase the risk of tendon rupture. Levaquin may affect blood glucose levels when used with antidiabetic agents. Dose reduction of drugs primarily eliminated by active renal secretion (such as probenecid) may be necessary.

Missed dose

If a dose is missed, take it 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 one. Continue with the regular dosing schedule. Maintaining consistent antibiotic levels is important for effectiveness and resistance prevention. If multiple doses are missed, contact the healthcare provider for guidance on how to proceed with treatment.

Overdose

In case of overdose, symptomatic and supportive care is recommended. ECG monitoring is advised due to potential QT prolongation. Levofloxacin is not effectively removed by hemodialysis or peritoneal dialysis. Manage seizures with benzodiazepines; maintain airway and oxygenation. Hydration is important to prevent crystal formation in urine. Specific antidotes are not available. Contact poison control center (1-800-222-1222) for latest guidance on management. Provide supportive care for any organ system affected.

Storage

Store Levaquin tablets at room temperature (20-25°C or 68-77°F) in the original container. Protect from light and moisture. Keep out of reach of children and pets. Do not store in bathroom cabinets where humidity may affect stability. Do not use if the seal is broken or tablets appear discolored or damaged. Properly discard any unused medication after completing treatment course. IV solutions should be stored according to manufacturer instructions and administered within specified time frames after preparation.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Levaquin is a prescription medication that should only be used under the supervision of a qualified healthcare professional. The prescribing physician will determine the appropriate treatment based on individual patient factors, infection type, susceptibility patterns, and risk-benefit assessment. Patients should discuss all medical conditions and medications with their healthcare provider before starting treatment. Serious side effects may occur requiring immediate medical attention.

Reviews

Clinical studies demonstrate Levaquin’s efficacy in approved indications. In multicenter trials for complicated urinary tract infections, clinical success rates ranged from 75-89%. For community-acquired pneumonia, success rates of 92-96% were reported. Dermatologic studies showed 76-86% success rates for skin structure infections. Many clinicians report positive experiences with Levaquin for appropriate indications when used according to guidelines. However, increasing antimicrobial resistance patterns and safety concerns have led to more restricted use in recent years. Healthcare providers emphasize the importance of reserving Levaquin for situations where benefits clearly outweigh risks and alternative treatments are inadequate.