What is the age limit for using Levaquin (levofloxacin)?

From the Guidelines

Levaquin (levofloxacin) should not be used in patients under 18 years of age due to the risk of arthrotoxicity and other adverse events, as stated in the guidelines for the systemic use of fluoroquinolones in children 1. The primary concern with using Levaquin in pediatric patients is the potential for joint damage, as fluoroquinolones have been associated with arthrotoxicity in juvenile animals and reversible musculoskeletal events in both children and adults 1. Some key points to consider when evaluating the use of Levaquin include:

• The increased risk of bacterial resistance to fluoroquinolones with their increased use in adults 1
• The availability of alternative antibiotics for treating infections in pediatric patients
• The need for careful consideration of the benefits and risks of using Levaquin in any patient, particularly in elderly patients or those with reduced kidney function, who may require dosage adjustments and are at a higher risk of side effects 1. In adults, there is no upper age limit for the use of Levaquin, but dosage adjustments may be necessary for elderly patients or those with reduced kidney function, and healthcare providers should be aware of the potential for increased side effects, including tendon inflammation or rupture, especially when taking corticosteroids simultaneously.

From the FDA Drug Label

Levofloxacin tablets are a fluoroquinolone antibiotic medicine used in adults age 18 years or older to treat certain infections caused by certain germs called bacteria Levofloxacin tablets are also used to treat children who are 6 months of age or older and may have breathed in anthrax germs, have plague, or been exposed to plague germs. It is not known if levofloxacin tablets are safe and effective in children under 6 months of age

The age limit for using Levaquin (levofloxacin) is:

• 18 years or older for adults
• 6 months or older for children, for specific conditions such as anthrax or plague
• Not established for children under 6 months of age 2
• Increased risk of severe tendon disorders in geriatric patients, especially those on corticosteroids 2

From the Research

Age Limit for Using Levaquin (Levofloxacin)

The age limit for using Levaquin (levofloxacin) is not explicitly stated in the provided studies. However, the following points can be considered:

• Fluoroquinolones, including levofloxacin, have not been recommended for use in children due to the potential risk of cartilage lesions 3.
• A study on the safety profile of levofloxacin in children found that the incidence of musculoskeletal disorders was greater in levofloxacin-treated children compared to nonfluoroquinolone-treated children 3.
• The majority of the studies on levofloxacin-induced tendonitis and tendon rupture involved adult patients, with ages ranging from 49.88 to 63.87 years 4.
• There are case reports of levofloxacin-induced tendonitis and tendon rupture in elderly patients, with ages ranging from 67 to 91 years 5, 6, 7.
• The use of fluoroquinolones, including levofloxacin, should be carefully considered in elderly patients, especially those treated with corticosteroids, due to the increased risk of tendon lesions 7.

Key Points to Consider

• The safety and efficacy of levofloxacin in children have not been established 3.
• Levofloxacin may increase the risk of musculoskeletal disorders in children 3.
• The risk of tendonitis and tendon rupture associated with levofloxacin use is more commonly reported in adult patients, particularly in those over 50 years of age 4.
• Elderly patients, especially those treated with corticosteroids, should be cautious when using levofloxacin due to the increased risk of tendon lesions 7.