Levofloxacin Hikma Farmacêutica (Levofloxacin)

Levofloxacin is a broad‑spectrum antibacterial indicated for several infection types.

• Respiratory tract infections: effective against community‑acquired pneumonia and acute exacerbations of chronic bronchitis.
• Urinary tract infections: treats complicated and uncomplicated infections caused by susceptible Gram‑negative organisms.
• Skin and soft tissue infections: active against cellulitis, wound infections and diabetic foot infections.
• Intra‑abdominal infections: used for peritonitis and intra‑abdominal abscesses when combined with appropriate anaerobic coverage.
• Septicemia: employed in systemic infections caused by susceptible bacteria.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA supercoiling and replication. By binding to these enzymes, it prevents the unwinding of DNA, halting bacterial replication and transcription, which leads to bacterial cell death. The drug exhibits concentration‑dependent bactericidal activity against a wide range of Gram‑positive and Gram‑negative organisms.

Levofloxacin may cause a variety of adverse reactions, ranging from mild to severe.

Common Side Effects

• Nausea: mild gastrointestinal upset.
• Diarrhea: watery stools, often self‑limiting.
• Headache: transient cranial discomfort.
• Dizziness: occasional vertiginous sensation.
• Rash: mild erythematous skin eruptions.
• Elevated liver enzymes: transient increase in hepatic transaminases.

Serious or Rare Side Effects

• Tendon rupture: especially Achilles tendon, may occur during or after therapy.
• QT prolongation: risk of cardiac arrhythmias.
• Central nervous system effects: seizures, confusion, hallucinations.
• Severe allergic reactions: anaphylaxis, Stevens‑Johnson syndrome.
• Clostridioides difficile colitis: antibiotic‑associated diarrhea.
• Hepatotoxicity: rare cases of liver injury.

Levofloxacin should be used with caution and under professional supervision.

• Renal impairment: adjust dose or monitor renal function.
• History of tendon disorders: avoid use in patients with prior tendon injury.
• Cardiac risk: avoid in patients with known QT prolongation or electrolyte disturbances.
• CNS disorders: monitor for seizures or neuropsychiatric symptoms.
• Pregnancy and lactation: safety not established; use only if benefits outweigh risks.
• Storage: Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze.

Levofloxacin can interact with several drug classes, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: markedly reduce levofloxacin absorption.
• Warfarin: may increase anticoagulant effect, raising bleeding risk.
• Theophylline: can raise plasma theophylline levels, leading to toxicity.

Moderate Interactions (Monitor Closely)

• NSAIDs: may increase risk of central nervous system stimulation.
• Cyclosporine: may raise cyclosporine concentrations.
• Corticosteroids: combined use may heighten tendon rupture risk.