Description
Levofloxacin Pharmacodynamics
Levofloxacin is a synthetic broad-spectrum antibacterial drug of the group of fluoroquinolones, containing levofloxacin as an active substance – the left-handed isomer ofloxacin.
Mechanism of Action: Levofloxacin blocks DNA-giase and topoisomerase IV, disrupts superspiralization and cross-linking of DNA breaks, inhibits DNA synthesis, causes profound morphological changes in cytoplasm, cell wall and membranes of microbial cells.
Levofloxacin is active against most strains of microorganisms both in vitro and in vivo.
Indications
Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to levofloxacin:
– community-acquired pneumonia;
– complicated urinary tract infections and pyelonephritis;
– chronic bacterial prostatitis;
– Skin and soft tissue infections;
– for complex treatment of drug-resistant forms of tuberculosis;
– Prevention and treatment of anthrax with an airborne route of infection.
For treatment of the following infectious and inflammatory diseases, levofloxacin may be used as an alternative to other antimicrobial agents:
– acute sinusitis;
– exacerbation of chronic bronchitis;
– uncomplicated cystitis.
When using Levofloxacin, the official national recommendations for the appropriate use of antibacterial agents, as well as the sensitivity of pathogens in a particular country should be taken into account (see section “Special indications”).
Contraindications
Hypersensitivity to levofloxacin or other quinolones or to any of the excipients of the drug, epilepsy, tendon involvement during previous treatment with fluoroquinolones, myasthenia pseudoparalytica (myasthenia gravis), pregnancy (the risk of fetal cartilage damage cannot be completely excluded), breastfeeding (the risk of cartilaginous bone growth zones in the child cannot be completely excluded), children and adolescents under 18 years of age (due to incomplete skeletal growth, as the risk of cartilaginous growth zones cannot be completely excluded).
Dosage and administration
- Levofloxacin, film-coated tablets 250 mg or 500 mg are taken orally once or twice a day. The tablets should be swallowed without chewing and with plenty of fluid (0.5 to 1 cup).
- If necessary, the tablets may be crushed at the risk.
The drug may be taken before meals or at any time between meals, because food intake does not affect absorption of the drug (see section “Pharmacokinetics”). - The drug should be taken at least 2 hours before or 2 hours after taking drugs containing magnesium and/or aluminum, iron, zinc, or sucralfate (see section “Interaction with other medicinal products”).
- Taking into account that bioavailability of levofloxacin when taking the drug in tablets is 99-100%, in case a patient is transferred from intravenous infusion of levofloxacin to taking tablets, treatment should be continued in the same dose that was used for intravenous infusion (see section “Pharmacokinetics”).
- Missing one or more doses of the drug
If the drug is accidentally missed, the next dose should be taken as soon as possible and then the drug Levofloxacin should be continued according to the recommended regimen. - Dosages and duration of treatment
The dosage regimen is determined by the nature and severity of the infection, as well as the sensitivity of the suspected pathogen. - The duration of treatment varies depending on the type of the disease.
- Recommended dosing regimen and duration of treatment in patients with normal renal function (creatinine clearance (CK) > 50 ml/min):
- Community-acquired pneumonia: 2 tablets of Levofloxacin 250 mg or 1 tablet of Levofloxacin 500 mg 1-2 times a day (500-1000 mg of levofloxacin, respectively) – 7-14 days;
- Complicated infections of the urinary tract: 2 tablets of the preparation Levofloxacin 250 mg once daily or 1 tablet of the preparation Levofloxacin 500 mg once daily (500 mg of levofloxacin, respectively) – 7-14 days;
- Pylonephritis: 2 tablets of the preparation Levofloxacin 250 mg once daily or 1 tablet of the preparation Levofloxacin 500 mg once daily (500 mg of levofloxacin, respectively) – 7-10 days.
- Chronic bacterial prostatitis: 2 tablets of the preparation Levofloxacin 250 mg or 1 tablet of the preparation Levofloxacin 500 mg once daily (500 mg of levofloxacin, respectively) – 28 days;
- Skin and soft tissue infections: 2 tablets of Levofloxacin 250 mg or 1 tablet of Levofloxacin 500 mg 1 to 2 times a day (500-1000 mg of levofloxacin, respectively) – 7-14 days;
- Complex treatment of drug-resistant forms of tuberculosis: 1 tablet of Levofloxacin 500 mg 1-2 times a day (500-1000 mg of levofloxacin, respectively) for up to 3 months.
- Prevention and treatment of anthrax in case of disseminated infection: 2 tablets of levofloxacin 250 mg or 1 tablet of levofloxacin 500 mg (500 mg of levofloxacin respectively) once a day for up to 8 weeks.
- Acute sinusitis: 2 tablets of Levofloxacin 250 mg or 1 tablet of Levofloxacin 500 mg once daily (500 mg of levofloxacin, respectively) for 10-14 days.
- Acute exacerbation of chronic bronchitis: 2 tablets of Levofloxacin 250 mg or 1 tablet of Levofloxacin 500 mg once daily (500 mg of levofloxacin respectively) – 7-10 days.
- Uncomplicated cystitis: 1 tablet of Levofloxacin 250 mg 1 time per day (respectively 250 mg of levofloxacin) – 3 days.
