Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Levofloxacin

C. diff Risk

High

Oral Bioavailability

NA

Approximate Cost

IV/PO$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Pediatric

Neonatal

10 mg/kg, IV, q12hr(s), Infuse over 60 minutes

10 mg/kg, PO, 2xdaily

Renal

Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing

Other

Dosing for oral and IV levofloxacin is identical. Not to be given IM or SC administration

General Information

Common Usage

Common Usage

Lower respiratory infection (CAP, HAP)

Intra-abdominal infection

Drug Monitoring

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

Adverse Effects

  • Dizziness

  • Insomnia

  • Rash

  • N/V

  • Abdominal pain

Reported:

  • Tendinopathy and rupture

  • Retinal detachment

  • Peripheral neuropathy

  • QTc prolongation

Major Interactions

Major Interactions

  • Increased risk when combined with other QTc prolonging agents

  • AVOID concomitant administration with antacids, multivitamin, and mineral supplements. Space doses by 2 hours

  • Increased risk of tendon rupture with concomitant use of corticosteroids

  • Monitor INR with warfarin

Pharmacology

Pharmacology

Antimicrobial class: Fluoroquinolone

Average serum half life:

  • Infants ≥6 months to 5 years: ~4 hours.

  • Children 5-16 years: 4.8-6 hours.

  • Adults: 6-8 hours

Route of Elimination: 87% excreted unchanged in urine over 48 hours by tubular secretion and glomerular filtration; 4% in feces