Levofloxacin Dosing for Geriatric Patients with Stenotrophomonas Infection and Renal Impairment

Dosing Considerations for Geriatric Patients

The American Geriatrics Society recommends calculating creatinine clearance to determine appropriate dosing for renally eliminated fluoroquinolones like levofloxacin in geriatric patients 1
For geriatric patients with CrCl 20-49 ml/min, the recommended dosing is 750 mg initially, then 750 mg every 48 hours 2
For geriatric patients with CrCl 10-19 ml/min, the recommended dosing is 500 mg initially, then 500 mg every 48 hours 2
For geriatric patients with severe renal impairment (CrCl <10 ml/min), the recommended dosing is 500 mg initially, then 500 mg every 48 hours 2
The American College of Critical Care Medicine recommends always initiating therapy with a full, high-end loading dose regardless of renal function to achieve peak plasma targets 2

The European Urology Association suggests that in frail or comorbid older individuals, fluoroquinolones should generally be avoided due to potential drug interactions and contraindications related to impaired kidney function 3, 4, 5, 6, 7