Criteria & Principles
Comparison of Fluoroquinolones:
FDA Black Box Warning: health care professionals should not prescribe systemic fluoroquinolones to patients who have other treatment options for acute bacterial sinusitis (ABS), acute bacterial exacerbation of chronic bronchitis (ABECB), and uncomplicated urinary tract infections (UTI) because the risks outweigh the benefits in these patients. Stop fluoroquinolone treatment immediately if a patient reports serious side effects, and switch to a non-fluoroquinolone antibacterial drug to complete the patient’s treatment course. These medicines are associated with disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system (such as irreversible peripheral neuropathy) that can occur together in the same patient.
Adjustment of Dose & Administration
Renal Adjustment
| Indication | CrCl (mL/min) | |||
| >50 | 20-49 | <20, IHD | CRRT | |
|
Infections cause by: Pseudomonas or Stenotrophomonas Lower respiratory tract infections Complicated UTI Bloodstream infection (e.g., E. coli BSI) |
750mg q24h | 750mg q48h | 750mg x 1 then 500mg q48h | 750mg x 1 then 500-750mg q24h |
|
Complicated SSTI Anti-bacterial prophylaxis (HOA patients) Non-TB Mycobacterium infection |
500mg q24h | 500mg x 1 then 250mg q24h | 500mg x 1 then 250mg q48h | 500mg x 1, then 250mg q24h |
Drug-Specific Information
Separate this medication by 2 hours before or 6 hours after the oral form of iron products; antacids containing aluminum, magnesium, or calcium; multivitamins containing zinc; oral nutritional supplements; or tube feedings, all of which may bind with this medication
Restricted Use
Levofloxacin is NO longer ID restriced as of 7/7/22.
General Notes
- Up-to-date cost information, click here
- IV antimicrobials outpatient (OPAT) dosing, click here
- Obesity dosing weight recommendations here
- Helpful drug-drug interaction check website here
- When dosing guidance is provided it is important to note the following:
Fixed (ie non weight-based) doses in adults are historically based on a 70 kg patient. Specific disease states or individual patients may warrant dosages that differ from the above recommendations. Since product-specific criteria for dose adjustment based on creatinine clearance exist, consult product information regarding specific recommendations for dosage adjustment based on estimated creatinine clearance.