What is the dosage of levofloxacin (Levaquin) for a chest infection?

From the Guidelines

For a chest infection, the recommended dosage of levofloxacin is 500 mg once daily, as stated in the guidelines for hospital-treated, non-pneumonic bronchial complications and non-severe pneumonia 1. The dosage may vary depending on the severity of the infection, with 500 mg once daily being the preferred dose for non-severe cases, and 500 mg twice daily being an alternative for severe pneumonia 1.

• Key points to consider when prescribing levofloxacin for a chest infection include:
  • The medication should be taken with plenty of water, and can be taken with or without food.
  • The full course of antibiotics should be completed, even if symptoms improve before finishing the treatment.
  • Patients with reduced kidney function may require lower doses.
  • Common side effects include nausea, diarrhea, headache, and dizziness.
  • Levofloxacin belongs to the fluoroquinolone class of antibiotics and works by inhibiting bacterial DNA gyrase and topoisomerase IV. It's essential to note that levofloxacin should be used with caution in elderly patients and those with a history of tendon disorders, as fluoroquinolones have been associated with an increased risk of tendon rupture, although this specific information is not mentioned in the provided guidelines 1.

From the FDA Drug Label

1. 2 Community-Acquired Pneumonia: 7 to 14 Day Treatment Regimen Adult inpatients and outpatients with a diagnosis of community-acquired bacterial pneumonia were evaluated in 2 pivotal clinical studies In the first study, 590 patients were enrolled in a prospective, multicenter, unblinded randomized trial comparing levofloxacin 500 mg once daily orally or intravenously for 7 to 14 days to ceftriaxone 1 to 2 grams intravenously once or in equally divided doses twice daily followed by cefuroxime axetil 500 mg orally twice daily for a total of 7 to 14 days
2. 3 Community-Acquired Pneumonia: 5 Day Treatment Regimen To evaluate the safety and efficacy of the higher dose and shorter course of levofloxacin, 528 outpatient and hospitalized adults with clinically and radiologically determined mild to severe community-acquired pneumonia were evaluated in a double-blind, randomized, prospective, multicenter study comparing levofloxacin 750 mg, IV or orally, every day for five days or levofloxacin 500 mg IV or orally, every day for 10 days.

The dosage of levofloxacin for a chest infection is:

• 500 mg once daily orally or intravenously for 7 to 14 days
• 750 mg once daily orally or intravenously for 5 days 2

From the Research

Dosage of Levofloxacin for Chest Infection

The dosage of levofloxacin for a chest infection, specifically community-acquired pneumonia (CAP), has been studied in several clinical trials.

• The recommended dosage of levofloxacin for CAP is 500mg once or twice daily for 5 to 14 days 3.
• A higher dosage of 750mg once daily for 5 days has also been shown to be effective in treating CAP, with a clinical success rate of 95.5% 4.
• Another study compared the efficacy and safety of levofloxacin 750mg for 5 days versus 500mg for 7-14 days and found that the 750mg regimen was at least as effective and well-tolerated as the 500mg regimen 5.
• In patients with severe nosocomial pneumonia, sequential therapy with levofloxacin 750mg once daily was as effective as intravenous imipenem/cilastatin (+/- oral switch to ciprofloxacin) 3.
• Levofloxacin has also been shown to be effective in treating acute exacerbations of chronic bronchitis, with a dosage of 250 or 500mg once daily being at least as effective as other antibiotics 3.

Efficacy and Safety

The efficacy and safety of levofloxacin in treating chest infections have been well-established in several studies.

• Levofloxacin has been shown to have a broad range of activity against Gram-positive and -negative organisms and anaerobes 3.
• The drug has a good safety profile, with most adverse drug reactions being mild in severity and well-tolerated 5.
• Levofloxacin has also been shown to be cost-saving in comparison to conventional therapies 3.
• A study comparing levofloxacin to ceftriaxone and azithromycin combination in the treatment of CAP found that monotherapy with oral levofloxacin was as effective as treatment with ceftriaxone plus azithromycin combination 6.