Levaquin (levofloxacin) is a broad-spectrum fluoroquinolone antibiotic indicated for the treatment of adults with serious bacterial infections. This advanced-generation antimicrobial agent demonstrates excellent tissue penetration and bactericidal activity against a wide range of Gram-positive and Gram-negative pathogens. With its proven clinical efficacy across multiple infection sites, Levaquin remains a valuable therapeutic option when conventional antibiotics prove insufficient. Proper patient selection and adherence to prescribing guidelines are essential for optimizing treatment outcomes while minimizing potential 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 Streptococcus pneumoniae
• Excellent bioavailability with approximately 99% oral absorption
• Penetrates effectively into tissues and body fluids including prostate, lung, and skin
• Bactericidal action through inhibition of bacterial DNA gyrase and topoisomerase IV

Benefits

• Effective against multidrug-resistant pathogens where other antibiotics fail
• Rapid bacterial eradication due to concentration-dependent killing
• Convenient once-daily dosing regimen improves patient compliance
• Suitable for sequential therapy (IV to oral) facilitating early discharge
• Comprehensive coverage for both community-acquired and hospital-acquired infections
• Proven efficacy in complicated infections including those with biofilm formation

Common use

Levaquin is indicated for the treatment of adults with complicated urinary tract infections, acute pyelonephritis, chronic bacterial prostatitis, complicated skin and skin structure infections, nosocomial pneumonia, community-acquired pneumonia, and acute bacterial sinusitis. It is also approved for inhalational anthrax exposure and plague. The antibiotic demonstrates particular utility in infections caused by Gram-negative organisms including Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, as well as certain Gram-positive pathogens including methicillin-susceptible Staphylococcus aureus and Streptococcus pneumoniae.

Dosage and direction

The recommended dosage varies by infection type and severity. For most indications, the usual dose is 250mg to 750mg administered orally or intravenously once every 24 hours. Treatment duration typically ranges from 7 to 14 days, though some infections may require extended therapy. Dosage adjustment is necessary in patients with renal impairment (creatinine clearance <50 mL/min). Administration should occur at least 2 hours before or 2 hours after antacids containing magnesium or aluminum, sucralfate, metal cations such as iron, or multivitamins containing zinc. Patients should maintain adequate hydration during treatment.

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. The drug may exacerbate muscle weakness in patients with myasthenia gravis. Peripheral neuropathy may occur and can be irreversible. Central nervous system effects including seizures, increased intracranial pressure, and psychiatric reactions have been reported. Photosensitivity reactions may occur, requiring sun avoidance and protective measures. Blood glucose disturbances may occur, particularly in diabetic patients. Regular monitoring of renal function is advised during treatment.

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 history of tendon disorders related to fluoroquinolone use. The drug should not be used in patients with known prolongation of the QT interval, uncorrected hypokalemia, or those taking Class IA or III antiarrhythmic agents. Concomitant use with tizanidine is contraindicated. Levaquin is not recommended for patients under 18 years of age except for specific indications where benefit outweighs risk.

Possible side effect

Common adverse reactions (≥1%) include nausea, diarrhea, headache, constipation, insomnia, dizziness, and abdominal pain. Serious side effects requiring immediate medical attention include tendon rupture, peripheral neuropathy, central nervous system effects (seizures, increased intracranial pressure, psychosis), QT prolongation and torsades de pointes, hypersensitivity reactions, hepatotoxicity, blood disorders, and Clostridium difficile-associated diarrhea. Musculoskeletal disorders including arthralgia, myalgia, and gait disturbances may occur. Visual disturbances including diplopia and reduced visual acuity have been reported.

Drug interaction

Levaquin exhibits several significant drug interactions. Concurrent use with nonsteroidal anti-inflammatory drugs may increase seizure risk. Antacids, sucralfate, iron preparations, and zinc-containing products significantly reduce absorption. Warfarin coadministration may enhance anticoagulant effect requiring frequent INR monitoring. QT-prolonging agents (antiarrhythmics, antipsychotics, antidepressants, macrolides) may increase arrhythmia risk. Diabetic agents may require dosage adjustment due to potential hypoglycemia. corticosteroids may increase tendon rupture risk. Theophylline levels may be elevated, requiring monitoring. Probenecid may decrease renal elimination of levofloxacin.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed dose. Consistent timing of administration helps maintain stable drug concentrations for optimal antibacterial efficacy. Healthcare providers should be consulted if multiple doses are missed or if uncertainty exists about proper dosing resumption.

Overdose

Symptoms of overdose may include dizziness, tremor, nausea, vomiting, decreased consciousness, and seizures. ECG monitoring is recommended due to potential QT prolongation. Management is supportive with careful observation and symptomatic treatment. Hemodialysis removes approximately 14% of the administered dose and may be considered in severe cases. There is no specific antidote for levofloxacin overdose. Gastric lavage may be considered if performed soon after ingestion. Patients should receive adequate hydration and monitoring for at least 48 hours following overdose.

Storage

Store Levaquin tablets at controlled room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Protect from light and moisture. Keep in the original container with the lid tightly closed. Do not store in bathroom or kitchen where humidity and temperature variations may occur. Keep out of reach of children and pets. Intravenous solutions should be stored according to manufacturer recommendations and protected from light. Do not freeze. Properly discard any unused medication after treatment completion or expiration date.

Disclaimer

This information is provided 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. Individual patient factors including medical history, current medications, and specific infection characteristics must be considered when determining appropriate therapy. Patients should consult their healthcare provider for personalized medical advice and report any adverse reactions promptly. The complete prescribing information should be reviewed before initiating treatment.

Reviews

Clinical studies demonstrate Levaquin’s efficacy across multiple infection types. In complicated urinary tract infections, clinical success rates exceed 85% in controlled trials. For community-acquired pneumonia, Levaquin shows superior efficacy compared to macrolides and cephalosporins in severe cases. Hospital-acquired pneumonia trials show comparable efficacy to imipenem with better tolerability. Dermatologists report excellent outcomes in complicated skin infections, particularly those with Gram-negative involvement. Infectious disease specialists note its value in multidrug-resistant infections while emphasizing appropriate patient selection. Most reviews highlight the importance of risk-benefit assessment given the potential for serious adverse effects.