Clinical beta
FMBM is currently in clinical beta. Content is for professional review/testing and must not replace local protocols, senior clinical judgment, or official prescribing references.
Drug Monograph
Levofloxacin
Fluoroquinolone (PO, IV)
Indication
CAP β’ HAP (susceptible) β’ sinusitis selected β’ complicated UTI β’ anthrax
INDICATIONS (CORE USE)
Respiratory + urinary + some SSTI β **same FQ class warnings** as cipro; **better pneumococcal activity** than cipro historically β still resistance matters.
ADULT DOSE (STANDARD)
500β750 mg PO/IV daily (indication-specific); CAP often 750 mg daily
MAX DOSE
750 mg/day typical adult max (some 500 mg indications)
Route
PO, IV
PEDIATRIC DOSE
Reserved protocols only
Must-not-miss safety points
Major warning
- Tendon rupture - QT prolongation - CNS effects - Aortic aneurysm / dissection class warning
USE IF: CAP, complicated UTI, sinusitis when guideline supports and resistance acceptable. AVOID IF: Uncomplicated UTI alternatives exist; children; prolonged QT.
Primary
Secondary
Other
STANDARD (ADULT PO)
500β750 mg PO/IV once daily (indication-specific; renal adjust CrCl <50)
ADULT DOSE
750 mg daily short-course CAP some guidelines; 500 mg daily other indications
PEDIATRIC DOSE
Specialist.
MAX DOSE
750 mg/day usual ceiling
Practical Note
Renal dose CrCl <50 per label β big dose reductions.
Clinical warnings
Adverse effects
Pediatrics
Reserved protocols only
Pregnancy
Avoid pregnancy
Lactation
caution.
Renal impairment
**Mandatory** adjustment CrCl <50 (often 250β500 mg q48h etc.) β follow label table. **CrCl scaffold (FMBM β titrate to FDA/SFDA label + institutional pharmacy nomogram):** - **CrCl β₯50** β standard (agent-specific) - **CrCl 10β50** β extend interval or β dose (**moxifloxacin:** often minimal CrCl change β hepatic clearance) - **CrCl <10** β label tables (cipro/levo often q24β48h); **seizure/QT risk** if accumulated; **HD:** consult pharmacy
Hepatic impairment
No major adjustment.
Elderly
Renal dosing + tendon + QT.
PO/IV; separate from iron/zinc.
Clinical Picture
**Life-threatening (first):** **seizures**; **torsades** (QT); **suicidal ideation** with agitation. **Secondary:** tendinopathy; GI symptoms.
Immediate Actions
Stop FQ β seizure precautions; ECG; correct electrolytes; glucose check if altered MS
Antidote
No specific antidote; treat complications (e.g. anaphylaxis β epinephrine per ACLS)
Decontamination
Recent PO overdose β charcoal if early
Escalation
Seizures, torsades, severe agitation β **ICU** / psychiatry; **severe toxicity with renal failure β consider hemodialysis** (limited for many FQs but case-by-case + supportive AKI) β nephrology + pharmacy
Common mistakes, resistance logic, and bedside traps
FQ with **daily** convenience for CAP/UTI. **Renal dose** tables are non-optional. Same tendon/QT baggage as class.
Stewardship: beta-lactam often preferred CAP inpatient. Shortest effective duration. Avoid FQ monotherapy sepsis of unknown source empirically in many pathways. *Stewardship (all antimicrobials):* Empiric choice β syndrome severity + **local antibiogram**; shortest effective course.
Pharmacy Tool
solution Β· oral
Pharmacist verification beta
Preparation formulas are currently in pharmacist verification beta and must be validated against institutional protocols before use.
Acknowledge the statements above to unlock volume scaling and ingredient quantities.
Once-daily; renal elimination; good alveolar penetration.
Fluoroquinolone β dual target DNA enzymes.
Global data (no country-specific data available)
Saudi Arabia
(placeholder β verify local formulary)
Common trade names are curated examples only β formulations and availability vary. Verify the exact product name with your local pharmacy and national regulator before prescribing or dispensing.
Saudi Arabia
International