UMEM Educational Pearls - By Jill Logan

Title: Levofloxacin dosing for CAP

Category: Pharmacology & Therapeutics

Keywords: Levofloxacin, duration, dose, CAP, pneumonia (PubMed Search)

Posted: 7/1/2017 by Jill Logan (Updated: 11/21/2024)
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When you look up dosing for levofloxacin for community acquired pneumonia (CAP), you will find that both of the following options are approved:

Levofloxacin 500 mg IV/PO daily x 7-14 days
Levofloxacin 750 mg IV/PO daily x 5 days

This is based on a multicenter, randomized, double-blind, active treatment trial comparing these two regimens in CAP (mild to severe). This non-inferiority trial shows that the 750 mg dose of levofloxacin for 5 days is "at least as effective and well tolerated" as the 500 mg dose of levofloxacin for 10 days.

So why should you choose the 750 mg daily x 5 day regimen?

Higher doses maximize the concentration-dependent pharmacokinetic profile of the drug
Higher doses and shorter duration may be associated with less drug resistance
Patients subjectively report feeling better at day 3 with the higher dose regimen

As alway with levofloxacin, don't forget to renally dose adjust subsequent doses when writting a script or scheduled inpatient order for patients with reduced creatinine clearance!

Posted: 6/4/2017 by Jill Logan (Updated: 11/21/2024)
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The incidence of Staphylococcus aurea as a urinary pathogen is increasing, however, this finding may represent more than a simple urinary tract infection.
One review found an 8-21%rate of association between S. aureus in the urine with bacteremia.
Additional work up, including blood cultures, may be warranted in patients with systemic symptoms, lack of access to follow up, and no urinary tract pathology or instrumentation.

UMEM Educational Pearls - By Jill Logan

Title: Levofloxacin dosing for CAP

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Title: S.aureus in the urine and the risk for bacteremia

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