What is the recommended dose and frequency of Levofloxacin for Community-Acquired Pneumonia (CAP)?

From the Guidelines

The recommended dose and frequency of Levofloxacin for Community-Acquired Pneumonia (CAP) is 750 mg daily for 5 days.

Key Points

• The American Thoracic Society and Infectious Diseases Society of America guidelines recommend levofloxacin as a treatment option for CAP, particularly for patients with severe disease or those at risk for drug-resistant pathogens 1.
• A study published in the American Journal of Respiratory and Critical Care Medicine found that a 5-day course of levofloxacin 750 mg daily was as effective as a 10-day course of levofloxacin 500 mg daily in treating CAP 1.
• The guidelines also suggest that the duration of antibiotic therapy can be reduced in patients with CAP, with a 5-day course being sufficient for many patients 1.
• Levofloxacin is a fluoroquinolone antibiotic with broad-spectrum activity against common CAP pathogens, including Streptococcus pneumoniae, Haemophilus influenzae, and atypical bacteria 1.
• The recommended dose and frequency of levofloxacin may vary depending on the severity of the disease, patient factors, and local resistance patterns, but 750 mg daily for 5 days is a commonly recommended regimen 1.

Important Considerations

• The choice of antibiotic and duration of therapy should be individualized based on patient factors, disease severity, and local epidemiology 1.
• Patients with CAP should be monitored for clinical response and adverse events, and the antibiotic regimen should be adjusted as needed 1.

From the FDA Drug Label

1.2 Community-Acquired Pneumonia: 7 to 14 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of community-acquired pneumonia due to methicillin-susceptible Staphylococcus aureus, Streptococcus pneumoniae (including multi-drug-resistant Streptococcus pneumoniae [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydophila pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae [see Dosage and Administration (2.1) and Clinical Studies (14.2)].

1.3 Community-Acquired Pneumonia: 5 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of community-acquired pneumonia due to Streptococcus pneumoniae (excluding multi-drug-resistant isolates [MDRSP]), Haemophilus influenzae, Haemophilus parainfluenzae, Mycoplasma pneumoniae, or Chlamydophila pneumoniae [see Dosage and Administration (2.1) and Clinical Studies (14.3)].

The recommended dose and frequency of Levofloxacin for Community-Acquired Pneumonia (CAP) are:

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

Key points:

• The dosage and duration of treatment depend on the severity of the infection and the causative pathogen.
• The 7 to 14 day treatment regimen is indicated for a broader range of pathogens, including multi-drug resistant Streptococcus pneumoniae (MDRSP).
• The 5 day treatment regimen is indicated for a more limited range of pathogens, excluding MDRSP.

From the Research

Recommended Dose and Frequency of Levofloxacin for Community-Acquired Pneumonia (CAP)

The recommended dose and frequency of Levofloxacin for Community-Acquired Pneumonia (CAP) are as follows:

• 500 mg once daily for 10 days 3, 4
• High-dose (750 mg) and short-course (5 days) of once-daily levofloxacin has been approved for use in the US in the treatment of CAP 3, 4, 5, 6

Rationale for the Recommended Dose and Frequency

The high-dose, short-course levofloxacin regimen:

• Maximizes its concentration-dependent antibacterial activity 3, 4, 6
• Decreases the potential for drug resistance 3, 4, 6
• Has better patient compliance due to the shorter duration of treatment and convenient once-daily administration schedule 6

Efficacy and Tolerability of Levofloxacin

The efficacy and tolerability of levofloxacin 500 mg once daily for 10 days in patients with CAP are well established 3, 4 The high-dose, short-course levofloxacin regimen has been shown to be noninferior to the 10-day regimen in CAP 6 Levofloxacin is generally well tolerated, with good tissue penetration and adequate concentrations maintained at the site of infection 3, 4, 6