A Review of Levofloxacin for the Treatment of Bacterial Infections

Noel, Gary J.
January 2009
Clinical Medicine: Therapeutics;2009, Issue 1, p433
Academic Journal
Completing its initial phases of drug development in the mid 1990s as the one of the fi rst fl uoroquinolones that could be used with confi dence to treat respiratory tract infections, levofl oxacin went on to become one of the most widely prescribed antibiotics in the world. Available in both oral (po) and intravenous (IV) formulations and with characteristics of over 90% bioavailability, distribution into both extracellular and intracellular pulmonary compartments, highly predictable pharmacokinetics with over 90% of the drug being excreted unchanged in urine, and reliable activity against a broad spectrum of clinically important pathogens, levofl oxacin has been used successfully to treat patients with a variety of serious infectious diseases as well as common infections most often treated outside of the hospital setting. Results of clinical trials involving patients with respiratory tract, urinary tract, and skin infections have consistently shown rates of clinical success and bacteriological eradication that were comparable to other widely used broad-spectrum agents. Regimens of levofl oxacin, initially involving total daily doses of 250 mg to 500 mg, but more recently regimens involving 750 mg doses, have been shown to be safe and effective. Nearly a decade and a half of clinical experience has defi ned a safety and tolerability profi le that permits data-driven assessment of the risks and benefi ts of using levofl oxacin. As resistance to currently available fl uoroquinolones has emerged, the clinical value of levofl oxacin deserves continued evaluation. However, consistently high rates of susceptibility of clinically important bacteria, especially among those bacteria that commonly cause respiratory tract infections, such as Streptococcus pneumoniae and Haemophilus infl uenzae, suggest that this agent will continue to be a widely used well past the 20-year anniversary of its introduction into the antibacterial armamentarium.


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