Levofloxacin Dosage for Ureaplasma Urinary Infection

Primary Dosing Recommendation

The Centers for Disease Control and Prevention (CDC) recommends levofloxacin 500 mg orally once daily for 7 days as an alternative regimen for nongonococcal urethritis (NGU), which includes ureaplasma as a causative organism 1, 2, 3, 4
First-line therapy for ureaplasma urethritis remains azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days, according to the CDC 1, 2, 3, 4

Levofloxacin should be used when a patient has failed first-line therapy with doxycycline or azithromycin, as recommended by the CDC 1, 2
The CDC also recommends using levofloxacin when tetracycline-resistant U. urealyticum is suspected, particularly after doxycycline failure 1, 2, 3, 4
Patients with contraindications to macrolides or tetracyclines should be treated with levofloxacin, according to the CDC 1, 2

The CDC recommends always obtaining urine culture before initiating therapy to document urethritis and identify the causative organism 1, 2, 3, 4
Objective signs of urethritis must be present, such as urethral discharge, >10 WBCs per high-power field on first-void urine, or positive leukocyte esterase, before treatment, as recommended by the CDC 1, 2, 3, 4
Patients should be instructed to abstain from sexual intercourse for 7 days after initiating therapy and ensure sex partners are evaluated and treated, according to the CDC 1, 2, 3, 4

Patients should return for evaluation only if symptoms persist or recur after completing therapy, as recommended by the CDC 1, 2, 3, 4
Symptoms alone without objective signs of urethritis are not sufficient basis for re-treatment, according to the CDC 1, 2, 3, 4
If symptoms persist despite appropriate therapy and compliance, the CDC recommends considering testing for Trichomonas vaginalis and evaluating for other causes 1, 2, 3, 4