From the FDA Drug Label
2 Community-Acquired Pneumonia: 7 to 14 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of community-acquired pneumonia due to ... Legionella pneumophila, or Mycoplasma pneumoniae
3 Community-Acquired Pneumonia: 5 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of community-acquired pneumonia due to ... Mycoplasma pneumoniae, or Chlamydophila pneumoniae
Atypical pneumonia treatment with levofloxacin:
- Legionella pneumophila: Levofloxacin is indicated for the treatment of community-acquired pneumonia due to Legionella pneumophila.
- Mycoplasma pneumoniae: Levofloxacin is indicated for the treatment of community-acquired pneumonia due to Mycoplasma pneumoniae.
- Chlamydophila pneumoniae: Levofloxacin is indicated for the treatment of community-acquired pneumonia due to Chlamydophila pneumoniae. 1
From the Research
Levofloxacin is a recommended treatment option for atypical pneumonia, with a typical dosage of 750 mg once daily for 5 days or 500 mg once daily for 7-14 days, depending on the severity of the infection. The most recent and highest quality study 2 supports the use of levofloxacin in the treatment of atypical pneumonia, caused by pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella species.
Key Considerations
- Levofloxacin works effectively against common atypical pathogens by inhibiting bacterial DNA gyrase and topoisomerase IV, preventing DNA replication 3.
- Patients should take the medication with or without food, complete the full course even if feeling better, and stay hydrated.
- Important precautions include avoiding antacids, iron, or multivitamins within 2 hours of taking levofloxacin as they reduce absorption.
- Patients should be aware of potential side effects including tendon inflammation, QT prolongation, and rare but serious adverse reactions like tendon rupture, especially in older adults or those on corticosteroids.
Alternative Treatments
- Alternative treatments for atypical pneumonia include macrolides (azithromycin) or doxycycline if fluoroquinolones are contraindicated 4.
- Doxycycline has been shown to be as efficacious as levofloxacin in the treatment of community-acquired pneumonia, with the added benefit of being more economical 4.
Treatment Duration and Compliance
- The 750 mg, 5-day regimen of levofloxacin is often preferred for outpatient treatment due to better compliance 5.
- A high-dose, short-course levofloxacin regimen maximizes its concentration-dependent antibacterial activity, decreases the potential for drug resistance, and has better patient compliance 3.