Levofloxacin, an oral
fluoroquinolone antibacterial agent, is the optical S-(-) isomer of
ofloxacin. In vitro it is generally twice as potent as
ofloxacin.
Levofloxacin is active against most aerobic Gram-positive and Gram-negative organisms and demonstrates moderate activity against anaerobes.
Drug penetration into body tissues and fluids is rapid and widespread after
oral administration. In clinical trials conducted in Japan, oral
levofloxacin has demonstrated antibacterial efficacy against a variety of
infections, including upper and lower respiratory tract, genitourinary, obstetric, gynaecological and skin and soft tissues. In comparative trials with
ofloxacin,
levofloxacin, at half the daily dosage of
ofloxacin, showed equivalent efficacy and a reduced incidence of adverse effects in the treatment of lower respiratory tract and complicated
urinary tract infections.
Levofloxacin has a tolerability profile similar to that of other oral
fluoroquinolones, with gastrointestinal and central nervous system effects reported most commonly.
Theophylline dosage adjustment does not appear to be necessary in patients receiving concomitant
levofloxacin. Coadministration with
antacids or with other drugs containing divalent or trivalent
cations reduces
levofloxacin absorption. Thus,
levofloxacin has potential as a broad spectrum antibacterial
drug in the treatment of a variety of
infections. However, clinical trials recruiting non-Japanese patients are in progress and these results will form a basis on which future recommendations for the broader use of
levofloxacin can be made.