Levofloxacin Kabi (Levofloxacin Hemihydrate)

• Levofloxacin is a fluoroquinolone antibiotic used to treat infections caused by susceptible bacteria.
• Community-acquired pneumonia: effective therapy to eradicate the causative bacterial pathogens and improve clinical outcomes.
• Complicated urinary tract infections: eradicates Gram‑negative and Gram‑positive organisms, facilitating resolution of infection.
• Skin and soft tissue infections: provides rapid bacterial clearance and promotes wound healing.
• Acute bacterial sinusitis: reduces bacterial load and alleviates sinus inflammation.
• Acute exacerbations of chronic bronchitis: shortens symptom duration and prevents further pulmonary deterioration.

• Levofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, and repair. By stabilizing the enzyme‑DNA complex, it prevents the resealing of DNA strands, leading to bacterial cell death. This bactericidal action is broad‑spectrum, affecting both Gram‑negative and Gram‑positive organisms that are susceptible to fluoroquinolones.

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

Common Side Effects

• Nausea or vomiting
• Diarrhea or loose stools
• Headache or dizziness
• Rash or mild skin irritation
• Elevated liver enzymes
• Transient increase in serum creatinine

Serious or Rare Side Effects

• Tendon rupture or tendonitis, especially in the Achilles tendon
• QT interval prolongation leading to cardiac arrhythmias
• Clostridioides difficile‑associated colitis
• Severe hypersensitivity reactions such as Stevens‑Johnson syndrome
• Peripheral neuropathy or central nervous system effects

• Levofloxacin should be used with caution in specific patient populations and clinical situations.
• Renal impairment: adjust dose or monitor renal function closely.
• History of tendon disorders: avoid use due to risk of tendon rupture.
• QT prolongation risk: avoid in patients with known cardiac arrhythmias or electrolyte disturbances.
• Concurrent NSAIDs or corticosteroids: monitor for additive CNS or tendon toxicity.
• Pregnancy and lactation: prescribe only if potential benefit outweighs potential risk.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Levofloxacin can interact with several medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Other fluoroquinolones or quinolone‑containing products: additive risk of QT prolongation.
• Anti‑arrhythmic agents (e.g., sotalol, amiodarone): may precipitate serious cardiac rhythm disturbances.
• Antacids or supplements containing magnesium, aluminum, calcium, or iron: markedly reduce levofloxacin absorption.

Moderate Interactions (Monitor Closely)

• Warfarin: may enhance anticoagulant effect, requiring INR monitoring.
• Theophylline: levofloxacin can increase serum theophylline levels, risking toxicity.
• NSAIDs: combined use may increase risk of CNS stimulation and seizures.
• Corticosteroids: concurrent therapy may raise the likelihood of tendon injury.