Treatment of Tuberculosis with Levofloxacino

Introduction to Levofloxacino Treatment

The Centers for Disease Control and Prevention recommends levofloxacino as the preferred oral agent for the treatment of drug-resistant tuberculosis when the organisms are known or presumed to be susceptible to this class of medications 1, 2
The recommended dose for adults is 500-1000 mg daily, available in both oral formulations and intravenous solution 1, 3

The choice between oral and intravenous levofloxacino should be based on the patient's ability to tolerate oral medications 2
The severity of the disease should also be considered when choosing the route of administration 2
Renal function is important, as levofloxacino is primarily eliminated by the renal route 5

In patients with renal insufficiency (creatinine clearance <50 ml/minute), the dose should be adjusted to 750-1000 mg three times a week 6
No supplemental doses are needed after hemodialysis, as levofloxacino is not removed by this process 7
Liver disease does not affect levofloxacino levels, but close monitoring is recommended 8
Administration with antacids or other medications containing divalent cations decreases fluoroquinolone absorption, so levofloxacino should not be given within 2 hours of these medications 9

Levofloxacino is generally well-tolerated, with adverse effects including gastrointestinal disorders (0.5-1.8% of patients) 2
Neurological effects, such as dizziness, insomnia, tremors, and headache, occur in 0.5% of patients 2
Skin reactions, including rash, pruritus, and photosensitivity, occur in 0.2-0.4% of patients 2