Levoflox (levofloxacin) is a third-generation fluoroquinolone antibiotic indicated for the treatment of adults with serious bacterial infections. As the L-isomer of ofloxacin, it demonstrates enhanced antibacterial activity with superior tissue penetration and bioavailability. This synthetic chemotherapeutic agent exhibits concentration-dependent bactericidal activity against a wide spectrum of Gram-positive and Gram-negative aerobic microorganisms. Its optimized pharmacokinetic profile allows for once-daily dosing in most indications, supporting improved patient compliance and therapeutic outcomes.

Features

• Active ingredient: Levofloxacin hemihydrate equivalent to 250mg, 500mg, or 750mg levofloxacin
• Pharmaceutical form: Film-coated tablets for oral administration
• Mechanism: Inhibits bacterial DNA gyrase and topoisomerase IV enzymes
• Spectrum: Broad coverage including Pseudomonas aeruginosa, Streptococcus pneumoniae, and Staphylococcus aureus
• Bioavailability: Approximately 99% with rapid absorption
• Half-life: 6–8 hours permitting once-daily dosing
• Excretion: Primarily renal unchanged (87% within 48 hours)

Benefits

• Rapid bactericidal action achieving prompt infection control
• Extensive tissue penetration reaching therapeutic concentrations at infection sites
• Convenient once-daily dosing regimen enhancing adherence
• Broad-spectrum coverage reducing need for combination therapy
• Proven efficacy in complicated urinary tract, respiratory, and skin structure infections
• Well-established safety profile with extensive clinical experience

Common use

Levoflox is indicated for the treatment of adults with 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 is particularly valuable in cases where first-line antibiotics have failed or when multidrug-resistant pathogens are suspected. The medication demonstrates excellent activity against atypical pathogens including Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydia pneumoniae.

Dosage and direction

Administer tablets orally with a full glass of water, with or without food, at approximately the same time each day. The recommended dosage varies by indication:

• Complicated urinary tract infections or acute pyelonephritis: 250 mg once daily for 10 days
• Complicated skin and skin structure infections: 750 mg once daily for 7–14 days
• Community-acquired pneumonia: 750 mg once daily for 7–14 days
• Acute bacterial sinusitis: 750 mg once daily for 5 days or 500 mg once daily for 10–14 days
• Acute bacterial exacerbation of chronic bronchitis: 500 mg once daily for 7 days

Dosage adjustment is required in patients with renal impairment (creatinine clearance <50 mL/min). For patients on hemodialysis or continuous ambulatory peritoneal dialysis, administer after dialysis.

Precautions

Patients should maintain adequate hydration to prevent crystal formation. Avoid excessive sunlight or artificial UV light due to photosensitivity risk. Use with caution in patients with known or suspected central nervous system disorders that may predispose to seizures. Monitor blood glucose levels in diabetic patients, as dysglycemia has been reported. Tendon inflammation or rupture may occur during or after therapy, particularly in elderly patients and those receiving concomitant corticosteroid therapy. Discontinue immediately if patient experiences pain, inflammation, or tendon rupture.

Contraindications

Levoflox is contraindicated in patients with known hypersensitivity to levofloxacin, other quinolone antimicrobial agents, or any component of the formulation. Contraindicated in patients with history of tendon disorders related to fluoroquinolone use. Not recommended for use in patients with known prolongation of the QT interval, uncorrected hypokalemia, or those receiving Class IA or Class III antiarrhythmic agents. Avoid use in patients with myasthenia gravis due to potential exacerbation.

Possible side effect

Common adverse reactions (≥1%) include nausea, diarrhea, headache, constipation, insomnia, dizziness, and abdominal pain. Serious adverse reactions may include tendonitis and tendon rupture, peripheral neuropathy, central nervous system effects (seizures, anxiety, confusion), exacerbation of myasthenia gravis, QT prolongation and torsades de pointes, hypersensitivity reactions, hepatic toxicity, Clostridium difficile-associated diarrhea, and blood glucose disturbances. Discontinue immediately at first sign of tendon pain or inflammation.

Drug interaction

Concomitant administration with multivalent cation-containing products (antacids, sucralfate, metal cations, didanosine) significantly reduces absorption—administer at least 2 hours before or 4 hours after levoflox. NSAIDs may increase CNS stimulation and seizure risk. May enhance effects of warfarin—monitor prothrombin time. Concurrent use with corticosteroids may increase risk of tendon rupture. Drugs that prolong QT interval (antiarrhythmics, tricyclic antidepressants, macrolides) may have additive effects. May alter serum levels of cyclosporine—monitor levels.

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 the missed dose. Maintain the regular dosing schedule and contact your healthcare provider if multiple doses have been missed. Consistent dosing is important to maintain effective antibiotic concentrations.

Overdose

Symptoms may include dizziness, tremor, nausea, vomiting, decreased consciousness, and seizures. ECG monitoring is recommended due to potential QT prolongation. Management includes symptomatic and supportive care. Hemodialysis removes approximately 14% of the dose over 4 hours. Maintain adequate hydration and monitor renal function. There is no specific antidote for levofloxacin overdose.

Storage

Store at controlled room temperature 20°–25°C (68°–77°F) with excursions permitted between 15°–30°C (59°–86°F). Keep container tightly closed and protect from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication after completing the prescribed course.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication. The prescribing physician should be aware of the complete medical history of the patient. Not all possible uses, precautions, side effects, or interactions are listed here. Healthcare providers should reference the complete prescribing information.

Reviews

Clinical studies demonstrate levofloxacin efficacy rates of 85–95% across approved indications. In a multicenter trial of complicated urinary tract infections, clinical success rates reached 93% at test-of-cure visit. For community-acquired pneumonia, studies show 90% clinical success when following approved dosing regimens. The antibiotic maintains consistent activity against common pathogens with well-characterized resistance patterns. Post-marketing surveillance confirms the established safety profile when used appropriately according to prescribing guidelines.