From the Guidelines
Levofloxacin 750 mg taken once daily for 5 days is an appropriate treatment for a right upper lobe infiltrate, which likely represents pneumonia. This antibiotic regimen provides adequate coverage against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and atypical organisms like Mycoplasma and Legionella, as supported by the study published in Pediatrics 1. The 750 mg dose once daily for 5 days has been shown to be effective in treating pneumonia, with the advantage of shorter treatment duration.
Key points to consider when taking levofloxacin include:
- Take the medication with or without food at the same time each day
- Complete the entire 5-day course even if symptoms improve before finishing
- Drink plenty of fluids while taking this medication
- Be aware that levofloxacin may cause side effects including tendon inflammation or rupture, peripheral neuropathy, central nervous system effects, and QT interval prolongation, as noted in the guidelines for the management of adult lower respiratory tract infections 1
- Contact your healthcare provider if you experience severe dizziness, racing heartbeat, tendon pain, or worsening respiratory symptoms
It is also important to note that levofloxacin is a fluoroquinolone antibiotic that works by inhibiting bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and ultimately killing the bacteria. The increased dose of 750 mg daily is designed to overcome the most common mechanism for the development of fluoroquinolone resistance, as discussed in the study published in Pediatrics 1.
From the FDA Drug Label
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. Clinical success rates (cure plus improvement) in the clinically evaluable population were 90.9% in the levofloxacin 750 mg group and 91.1% in the levofloxacin 500 mg group.
The recommended dosage of levoFLOXacin for community-acquired pneumonia is 750 mg orally or IV every day for 5 days. The clinical success rate for this dosage is 90.9% 2.
- Key points:
- LevoFLOXacin 750 mg orally or IV every day for 5 days is a recommended treatment for community-acquired pneumonia.
- The clinical success rate for this treatment is 90.9%.
- This treatment is supported by a double-blind, randomized, prospective, multicenter study 2.
From the Research
Treatment of Right Upper Lobe Infiltrate with LevoFLOXacin
- The patient is prescribed levoFLOXacin 750 mg tablet, 1 tablet every day for 5 days for right upper lobe infiltrate.
- According to the study 3, a high-dose (750 mg), short-course (5 days) of once-daily levofloxacin has been approved for use in the USA in the treatment of community-acquired pneumonia (CAP).
- The efficacy and tolerability of levofloxacin 500 mg once daily for 10 days in patients with CAP are well established, and the high-dose, short-course levofloxacin regimen has been shown to be noninferior to the 10-day regimen in CAP 4.
- LevoFLOXacin has a broad spectrum of activity against several causative bacterial pathogens of community-acquired pneumonia (CAP), including Gram-positive and Gram-negative organisms and anaerobes 5.
- The high-dose, short-course levofloxacin regimen maximizes its concentration-dependent antibacterial activity, decreases the potential for drug resistance, and has better patient compliance 3, 4.
Efficacy of LevoFLOXacin in Treating Community-Acquired Pneumonia
- The clinical response rates with levofloxacin ranged from 86 to 95% versus 88 to 96% with comparator agents; bacteriological response rates were 88 to 95% and 86 to 98%, respectively 5.
- A 750-mg, 5-day course of levofloxacin was at least as effective as a 500-mg, 10-day regimen for atypical CAP, and may reduce total antimicrobial drug usage and more rapidly relieve pneumonia symptoms 6.
- LevoFLOXacin had a higher microbiological response rate overall, and for Gram-negative and non-pseudomonas Gram-negative pathogens than the combination therapy of amoxicillin/clavulanate plus clarithromycin 7.