What is the recommended dosage of Levaquin (levofloxacin) for treating sinusitis infection?

From the Guidelines

Levofloxacin (Levaquin) is typically prescribed at 500 mg once daily for 10-14 days for acute bacterial sinusitis in adults with normal kidney function, as recommended by recent guidelines 1.

Key Considerations

• The dosage may be increased to 750 mg once daily for more severe infections or complicated cases.
• Patients should complete the entire course of antibiotics even if symptoms improve before finishing the prescription.
• Common side effects include nausea, headache, and diarrhea.
• Levofloxacin works by inhibiting bacterial DNA gyrase and topoisomerase IV, which prevents bacterial DNA replication and ultimately kills the bacteria causing the infection.

Important Notes

• Levofloxacin should be reserved for infections that haven't responded to first-line antibiotics due to concerns about antibiotic resistance and potential side effects, as suggested by 1.
• Patients should stay well-hydrated while taking this medication and contact their healthcare provider if they experience tendon pain, joint problems, or severe diarrhea.

Treatment Duration

• The duration of treatment is usually 7–10 days, but may be extended to 10-14 days for more severe cases, as recommended by 1.

Special Considerations

• For patients with renal impairment, the dosage of levofloxacin may need to be adjusted, as recommended by 1.
• Patients with a history of tendonitis or tendon rupture should use levofloxacin with caution, as it may increase the risk of tendon damage.

From the FDA Drug Label

Levofloxacin is approved for the treatment of acute bacterial sinusitis (ABS) using either 750 mg by mouth x 5 days or 500 mg by mouth once daily x 10 to 14 days The recommended dosage of Levaquin (levofloxacin) for treating sinusitis infection is:

• 750 mg by mouth once daily for 5 days
• 500 mg by mouth once daily for 10 to 14 days 2

From the Research

Recommended Dosage of Levaquin (Levofloxacin) for Sinusitis Infection

The recommended dosage of Levaquin (levofloxacin) for treating sinusitis infection is:

• 500 mg orally once daily for 10 to 14 days 3, 4, 5
• A high-dose (750 mg) short-course (5 days) of once-daily levofloxacin is also approved for use in the US for the treatment of acute bacterial sinusitis (ABS) 6

Key Findings

• The clinical success rates for levofloxacin in the treatment of acute sinusitis were:

• 88.4% for the 267 clinically evaluable patients who received levofloxacin 500 mg orally once daily for 10 to 14 days 3
• 93.9% for clinically evaluable patients who received levofloxacin 500 mg orally once daily for 10-14 days 4
• 88% for 300 clinically evaluable patients who received levofloxacin 500 mg orally once daily for 10 to 14 days 5
• 94.1% for patients who received levofloxacin 500 mg orally once daily for 10 days 7

• The microbiologic eradication rates for levofloxacin in the treatment of acute sinusitis were:

• 92% among 138 microbiologically evaluable patients 5
• 93% to 100% for the most common pathogens, including Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus, and Moraxella catarrhalis 5

Adverse Events

• The most common adverse events associated with levofloxacin were:

• Nausea, diarrhea, vaginitis, and abdominal pain 3
• Diarrhea, flatulence, and nausea 5

• The proportion of patients who experienced adverse events related to levofloxacin was:

• 7.4% for patients who received levofloxacin 500 mg orally once daily for 10 to 14 days 3
• 9% for patients who received levofloxacin 500 mg orally once daily for 10 to 14 days 5