From the Guidelines
The recommended dose of Levofloxacin for the treatment of pneumonia is 750 mg once daily for 5 days, or 500 mg once daily for 7-14 days, administered orally or intravenously depending on severity. This recommendation is based on the most recent and highest quality study available, which suggests that levofloxacin is effective in treating community-acquired pneumonia in adults, including those with underlying comorbidities and those who have been exposed to antibiotic agents within the previous 3 months 1.
Key Considerations
- For hospitalized patients with more severe infections, the 750 mg dose is generally preferred 2.
- Dosage adjustments are necessary for patients with renal impairment: for creatinine clearance 20-49 mL/min, use 750 mg every 48 hours or 500 mg daily; for clearance 10-19 mL/min, use 750 mg initially then 500 mg every 48 hours, or 500 mg initially then 250 mg daily 1.
- Levofloxacin works by inhibiting bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and ultimately killing the bacteria.
- It has excellent lung penetration and broad coverage against common pneumonia pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and atypical organisms like Mycoplasma and Legionella.
Patient Advice
- Patients should be advised to maintain adequate hydration during treatment and report any tendon pain, as fluoroquinolones carry a risk of tendinopathy.
- The choice of levofloxacin should be based on the severity of the infection, the patient's underlying health status, and the likelihood of antibiotic resistance 3.
Clinical Context
- The guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents recommend using levofloxacin (750 mg/day) as part of the treatment regimen for severe pneumonia 2.
- The British Infection Society, British Thoracic Society, and Health Protection Agency guidelines suggest using levofloxacin as an alternative treatment for hospital-treated, non-severe pneumonia, and as a preferred treatment for hospital-treated, severe pneumonia 3.
From the FDA Drug Label
2.1 Dosage of Levofloxacin Tablets
Nosocomial Pneumonia
• Levofloxacin tablets should be administered as described in Table 1
...
Community-Acquired Pneumonia
• Levofloxacin tablets 500 mg every 24 hours for 7 to 14 days
The recommended dose of Levofloxacin for the treatment of pneumonia is:
- Nosocomial Pneumonia: The dose is described in Table 1, but the exact dose is not provided in the given text.
- Community-Acquired Pneumonia: 500 mg every 24 hours for 7 to 14 days 4
From the Research
Recommended Dose of Levofloxacin for Pneumonia
The recommended dose of Levofloxacin for the treatment of pneumonia is:
- 500 mg once daily for 10 days 5, 6, 7
- 750 mg once daily for 5 days, a high-dose, short-course regimen 5, 7, 8
Considerations for Dosage
The choice of dosage may depend on the severity of the disease, the susceptibility of the causative pathogen, and the patient's weight 9.
- For mild to moderately severe community-acquired pneumonia, 500 mg once daily may be sufficient 9.
- For severe community-acquired pneumonia, 750 mg once daily or 500 mg twice daily may be considered 9.
Efficacy of Levofloxacin
Levofloxacin has been shown to be effective in the treatment of community-acquired pneumonia, with clinical success rates of 92.4% for the 750-mg group and 91.1% for the 500-mg group 8.