Levofloxacin Kabi (Levofloxacin Hemihydrate)

Levofloxacin is a fluoroquinolone antibacterial indicated for several serious bacterial infections.

• Community‑acquired bacterial pneumonia: effective treatment to eradicate the causative pathogens and improve clinical outcomes.
• Acute bacterial sinusitis: helps clear infection and relieve sinus inflammation.
• Skin and soft‑tissue infections: provides bacterial eradication in cellulitis, abscesses, and wound infections.
• Complicated urinary tract infections: targets resistant uropathogens to resolve infection.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA supercoiling and replication. By binding to the ATP‑binding sites of these enzymes, it prevents DNA strand separation, halting bacterial DNA synthesis and transcription, leading to bactericidal activity. The drug penetrates well into respiratory tissues, sinuses, skin, and the urinary tract, achieving concentrations above the minimum inhibitory concentrations for susceptible strains.

Levofloxacin may cause a range of adverse reactions, varying in frequency and severity.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Diarrhea: loose stools, sometimes watery.
• Headache: transient cranial discomfort.
• Rash: mild skin erythema or itching.

Serious or Rare Side Effects

• Tendon rupture: sudden tendon pain or swelling, especially in the Achilles.
• QT prolongation: cardiac rhythm disturbances that may lead to arrhythmia.
• Severe hypersensitivity: anaphylaxis, angioedema, or Stevens‑Johnson syndrome.

Before using Levofloxacin, consider the following precautions to ensure safe administration.

• Renal impairment: adjust dose or monitor renal function in patients with reduced kidney clearance.
• History of tendon disorders: avoid in patients with prior tendon inflammation or recent corticosteroid therapy.
• Cardiac risk: caution in individuals with known QT prolongation or electrolyte abnormalities.
• Concomitant medications: review for drugs that may prolong QT interval or affect metabolism.
• Pregnancy and lactation: use only if clearly needed, as safety data are limited.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Levofloxacin can interact with other medicines, altering its efficacy or increasing toxicity.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: markedly reduce levofloxacin absorption; separate administration by at least 2 hours.
• Warfarin: may enhance anticoagulant effect, increasing bleeding risk; monitor INR closely.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): increased risk of central nervous system stimulation and seizures.

Moderate Interactions (Monitor Closely)

• Theophylline: levofloxacin can raise plasma theophylline levels; monitor for toxicity.
• Cyclosporine: may increase cyclosporine concentrations; adjust dose as needed.
• Diabetic agents (e.g., insulin, sulfonylureas): possible hypoglycemia; monitor blood glucose.