Levofloxacin

• A quinolone antibiotic similar to ofloxacin and ciprofloxacin.
• Excellent bioavailability (>90%) following oral administration.
• Excellent tissue penetration.
• Usual adult dose 500 mg po once daily (increased to BD for severe infection)
• Dose reduction necessary in renal impairment
• IV levofloxacin is NOT available in this hospital.
• Tablets disperse in water after 10 mins if swallowing is difficult.
• Use with caution in epileptics.
• Caution in elderly patients on steroids - risk of achilles tendonitis/rupture
• High risk of Clostridium difficile antibiotic-associated diarrhoea.
• Use linked to increased colonisation with MRSA

Main indications

• Microbiology advice.
• Restricted agent
• As Levofloxacin can increase selection for C.difficile infection and MRSA colonisation/infection, all patients with previous MRSA/C.difficile  require documented microbiology approval regardless of indication.

Active against most strains of:

• Streptococcus pneumoniae (but can't be relied on for pneumococcal septicaemia - add benzylpencillin)
• Haemophilus influenzae  and Moraxella catarrhalis
• Legionella
• Atypical pneumonia pathogens (Mycoplasma, Chlamydia)
• Coliforms (E.coli, Klebsiella, Enterobacter, Proteus)
• Staph.aureus (but NOT MRSA)
• Pseudomonas (slightly less active than ciprofloxacin)

Not active against most strains of:

• MRSA
• Enterococci
• Anaerobes (Clostridium, Bacteroides)

Page last edited: 09/10/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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