From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For USMLE Step 2, high-yield antibiotic coverage concepts focus on empiric therapy for common infections and understanding antibiotic classes, with a key concept being the use of levofloxacin as a respiratory fluoroquinolone for community-acquired pneumonia, as supported by the most recent study 1. Key testable concepts include:
- Empiric coverage for community-acquired pneumonia (combination of a respiratory fluoroquinolone like levofloxacin or a macrolide like azithromycin plus a beta-lactam such as ceftriaxone)
- Urinary tract infections (trimethoprim-sulfamethoxazole, nitrofurantoin, or fluoroquinolones)
- Meningitis (vancomycin plus ceftriaxone with addition of ampicillin for certain age groups)
- Skin/soft tissue infections (cephalexin for uncomplicated cases, vancomycin for MRSA concerns) You should understand antibiotic mechanisms of action, such as:
- Cell wall inhibitors (beta-lactams)
- Protein synthesis inhibitors (macrolides, aminoglycosides)
- DNA synthesis inhibitors (fluoroquinolones)
- Folate antagonists (trimethoprim-sulfamethoxazole) Know common side effects like:
- C. difficile colitis with broad-spectrum antibiotics
- Nephrotoxicity with aminoglycosides
- Tendon rupture with fluoroquinolones
- Bone marrow suppression with trimethoprim-sulfamethoxazole Understanding antibiotic resistance mechanisms is crucial, particularly:
- MRSA
- Extended-spectrum beta-lactamases (ESBLs)
- Vancomycin-resistant enterococci (VRE) These concepts are frequently tested because they represent core clinical knowledge that directly impacts patient care decisions in various clinical scenarios, as shown in the study comparing treatment failure rates of levofloxacin with other antibiotics 2. The most recent and highest quality study 1 provides a systematic review and meta-analysis of the effectiveness and safety of levofloxacin in the treatment of community-acquired pneumonia, which is essential for USMLE Step 2.