Levofloxacin Dosage for Urinary Tract Infections

Dosing Recommendations

• The European Urology guideline recommends levofloxacin 750 mg once daily for 5 days for complicated UTIs and acute pyelonephritis, or 250 mg once daily for 10 days for uncomplicated UTIs 1

Important Considerations

Antimicrobial Resistance

• The European Urology and Praxis Medical Insights guidelines suggest that fluoroquinolone resistance should be <10% in the local community for empiric use of levofloxacin 1, 2
• If fluoroquinolone resistance is thought to exceed 10%, an initial intravenous dose of a long-acting parenteral antimicrobial is recommended before starting levofloxacin 1, 3

Culture and Susceptibility Testing

• The Clinical Infectious Diseases guideline recommends that a urine culture and susceptibility test should always be performed before initiating therapy for complicated UTIs and pyelonephritis 3
• Therapy should be tailored based on culture results when available 2, 3

Special Populations

• The European Urology guideline recommends initial treatment with IV levofloxacin (750 mg once daily) for hospitalized patients with pyelonephritis, with transition to oral therapy once clinically improved 1, 2