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Levofloxacin is authorised in the world under the following brand names: Cravit, Cravit Ophthalmic, Elequine, Floxel, Iquix, Leroxacin, Lesacin, Levaquin, Levokacin, Levox, Levoxacin, Mosardal, Nofaxin, Quixin, Reskuin, Tavanic, Volequin.

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In patients with meningitis, levofloxacin penetration in cerebrospinal fluid and the liquor-to-plasma ratio was assessed at 2 hours after dosing in five patients with spontaneous acute bacterial meningitis. Cerebrospinal fluid levofloxacin concentration at 2 hours after dosing was 2.0 µg/ml, and the liquor-to-plasma ratio at 2 hours after dosing was 0.35. In 10 patients who took levofloxacin 500 mg/day and rifampicin 600 mg/day for 2-6 months, there were no adverse reactions in 46% of patients, occasional digestive symptoms in 40%, and mild diarrhea in 13%; these patients also took unspecified anti-inflammatory drugs.

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Preclinical and clinical trial data and data from phase IV studies have suggested that levofloxacin causes prolongation of the QT interval. There were cardiovascular problems in 1 in 15 million prescriptions compared with 1-3% of patients taking sparfloxacin, who had QTC prolongation to over 500 ms.

Cervicitis

Infectious cervicitis may be caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, ureaplasmas, Herpes simplex or Trichomonas vaginalis. Chronic cervicitis is characterized by inflammation of the cervix without an identified pathogen.

Antimicrobial therapy: general principles

A wide variety of antimicrobial agents is available to treat established infections caused by bacteria, fungi, viruses, or parasites. This section will cover the general principles of antimicrobial therapy and will also include illustrative clinical problems to emphasize proper decision-making in using antimicrobials.

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Levofloxacin is a fluoroquinolone anti-infective agent. Like other commercially available fluoroquinolones, levofloxacin contains a fluorine at the C-6 position of the quinolone nucleus. Like some other fluoroquinolones (ciprofloxacin, gatifloxacin, lomefloxacin, norfloxacin, ofloxacin, sparfloxacin), levofloxacin contains a piperazinyl group at C-7.

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Levofloxacin is used orally or IV for the treatment of respiratory tract infections (acute bacterial exacerbations of chronic bronchitis, acute maxillary sinusitis, community-acquired pneumonia, nosocomial pneumonia), uncomplicated or complicated skin and skin structure infections, uncomplicated or complicated urinary tract infections, acute pyelonephritis, and chronic prostatitis caused by susceptible organisms.

Community-Acquired Pneumonia: Current Therapies

Many highly effective agents are available for the treatment of bacterial community-acquired pneumonia (community-acquired pneumonia) and other community-acquire respiratory tract infections (RTIs). Currently marketed antibiotics for community-acquired pneumonia demonstrate similar efficacy rates in clinical trials, and these agents have generally achieved clinical symptom resolution in 85-95% of trial participants.

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Levofloxacin (Johnson & Johnson’s Levaquin, Sanofi-Aventis’ Tavanic, Daiichi’s Cravit) (Figure 12) is a widely successful fluoroquinolone approved for the treatment of community-acquired pneumonia and several other bacterial infections (e.g., bronchitis, urinary tract infection, skin infections). In the United States, the agent is a leading antibiotic for community-acquired pneumonia owing to its high bioavailability, broad-spectrum activity, tolerability, and once-daily dosing. Levofloxacin was first launched in Japan in 1993 and has been widely available since 1998. Most recently, a new, high-dose formulation (750 mg) has been approved that provides patients an abbreviated five-day treatment course for community-acquired pneumonia.

Gemifloxacin

Gemifloxacin, as a member of the fluoroquinolone class, acts by inhibiting bacterial topoisomerase IV and DNA gyrase. These enzymes are required for DNA replication, transcription, repair, and recombination.

Dosage forms of Levofloxacin:
Levaquin i.v. 25 mg/ml vial Quixin 0.5% Solution Quixin 0.5% eye drops Levaquin 250 mg tablet
Iquix 1.5% eye drops Levaquin 500 mg tablet Levaquin 750 mg leva-pak tablet Levaquin 750 mg tablet
Levofloxacin hemihydr 100% powder Iquix 1.5% Solution 5ml Bottle Levaquin 500 mg/100 ml d5w  

Synonyms of Levofloxacin:

L-Ofloxacin, Levofloxacin

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Therapeutic classes of Levofloxacin:

Anti-Bacterial Agents, Anti-Infective Agents, Urinary, Nucleic Acid Synthesis Inhibitors, Quinolones

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