levofloxacin (Rx)

Acute bacterial exacerbation of chronic bronchitis

Adult: PO/IV 500 mg q24 hr × 7 days Acute bacterial sinusitis

Adult: PO 500 mg q24 hr × 10-14 days or 750 mg q24 hr × 5 days Mild-moderate UTI/acute pyelonephritis

Adult: PO/IV 750 mg q24 hr × 5 days or 250 mg q24 hr × 10 days Chronic bacterial prostatitis

Adult: PO 500 mg q24 hr × 28 days Postexposure inhalational anthrax Adult/adolescent/child >50 kg: PO/IV 500 mg q24 hr × 60 days Infant >6 mo and child <50 kg: IV 8 mg/kg q12 hr × 60 days, max 250 mg/dose Pneumonia, community acquired

Adult: PO/IV 500 mg q24 hr × 7-14 days or 750 mg q24 hr × 5 days Pneumonia, nosocomial

Adult: PO/IV 750 mg q24 hr × 7-14 days SSSI, complicated

Adult: PO/IV 750 mg q24 hr × 7-14 days SSSI, uncomplicated

Adult: PO 500 mg q24 hr × 7-10 days UTI, complicated

Adult: PO/IV 750 mg q24 hr × 5 days or 250 mg q24 hr × 10 days UTI, uncomplicated

Adult: PO 250 mg q24 hr × 3 days Plague (Yersinia pestis)

Adult: PO/IV 500 mg q24 hr × 10-14 days (with pneumonia, 750 mg q24 hr) Adolescent/child <50 kg: PO/IV 8 mg/kg (max 250 mg/dose) q12 hr × 10-14 days Renal disease

Adult: PO/IV CCr 20-49 ml/min: for 750-mg dose, give 750 mg q48 hr; for 500-mg dose, give 500 mg once, then 250 mg q24 hr; for 250-mg dose, no adjustment; CCr 10-19 ml/min: for 750-mg dose, give 750 mg once, then 500 mg q48 hr; for 500-mg dose, give 500 mg once, then 250 mg q48 hr; for 250-mg dose, give 250 mg q48 hr, except when treating complicated UTI, then no dose adjustment

Available forms: Single-use vials (500, 750 mg), premixed flexible container; 250 mg/50 ml D5 W, 500 mg/100 ml D5 W, 750 mg/150 ml D5 W; tabs 250, 500, 750 mg; oral sol 25 mg/ml

Implementation - Obtain C&S before treatment and periodically - Give PO 2 hr before or 2 hr after antacids, iron, calcium, zinc; give fluids - Check for irritation, extravasation, phlebitis daily Oral solution: - Give 1 hr prior to or 2 hr after food

Intermittent IV infusion route: - Discard any unused sol in the single-dose vial - Visually inspect for particulate matter/discoloration prior to use IV (single use vial): - 500 mg/20 ml vials: To prepare a dose of 500 mg, withdraw 10 ml from a 20-ml vial and dilute with a compatible IV solution (D5 W, NS) to a total volume of 50 ml. To prepare a 500-mg dosage, withdraw all 20 ml from the vial and dilute with a compatible IV solution to a total volume of 100 ml - 750 mg/30 ml vials: To prepare a dose of 750 mg, withdraw 30 ml from a 30-ml vial and dilute with a compatible intravenous solution (D5 W, NS) to a total volume of 150 ml - The concentration of the diluted solution should be 5 mg/ml prior to administration. Solutions contain no preservatives; any unused portions must be discarded -

Storage: The diluted solution may be stored for up to 72 hours when stored at or below 25° C (77° F) or for 14 days when stored under refrigeration at 5° C (41° F) in plastic containers. Solutions may be frozen for up to 6 months (-20° C or -4° F) in glass bottles or plastic containers. Thaw frozen solutions at room temperature (25° C or 77° F) or in a refrigerator (8° C or 46° F). Do not force thaw by microwave or water bath immersion. Do not refreeze after initial thawing Premixed IV solution: - No dilution is necessary Intermittent IV injection: - Infuse doses of ≤500 mg IV over 60 minutes and doses of 750 mg IV over 90 minutes. Shorter infusions or bolus injections should be avoided because of the risk of hypotension

Y-site compatibilities: Alemtuzumab, alfentanil, amifostine, amikacin, aminocaproic acid, aminophylline, ampicillin, ampicillin-sulbactam, anidulafungin, argatroban, atenolol, atracurium, aztreonam, bivalirudin, bleomycin, bumetanide, buprenorphine, busulfan, butorphanol, caffeine citrate, calcium gluconate, CARBOplatin, carmustine, caspofungin, cefepime, cefoTEtan, ceftaroline, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chlorproMAZINE, cimetidine, cisatracurium, CISplatin, clindamycin, codeine, cyclophosphamide, cycloSPORINE, cytarabine, dacarbazine, DACTINomycin, DAPTOmycin, DAUNOrubicin liposomal, dexamethasone, dexrazoxane, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, dolasetron, DOPamine, doripenem, doxacurium, doxycycline, droperidol, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentaNYL, filgrastim, floxuridine, fluconazole, fludarabine, foscarnet, fosphenytoin, gallium, gemcitabine, gemtuzumab, gentamicin, granisetron, haloperidol, hydrocortisone, HYDROmorphone, IDArubicin, ifosfamide, imipenem-cilastatin, irinotecan, isoproterenol, labetalol, lepirudin, leucovorin, levorphanol, lidocaine, linezolid, mannitol, mechlorethamine, meperidine, mesna, methylPREDNISolone, metoclopramide, metroNIDAZOLE, midazolam, milrinone, minocycline, mitoMYcin, mitoXANtrone, mivacurium, morphine, mycophenolate mofetil, nalbuphine, naloxone, nesiritide, netilmicin, niCARdipine, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, PEMEtrexed, penicillin G sodium, pentamidine, phenylephrine, plicamycin, potassium acetate/chloride, promethazine, propranolol, quinupristin-dalfopristin, ranitidine, remifentanil, rocuronium, sargramostim, sodium bicarbonate, succinylcholine, SUFentanil, sulfamethoxazole-trimethoprim, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin, ticarcillin-clavulanate, tigecycline, tirofiban, tobramycin, topotecan, trimethobenzamide, vancomycin, vasopressin, vecuronium, verapamil, vinBLAStine, vinCRIStine, vinorelbine, voriconazole, zidovudine, zoledronic acid Solution compatibilities: 0.9% NaCl, D5 W, D5/0.9% NaCl, D5 LR, D5/0.45% NaCl, sodium lactate, plasma-lyte 56/D5 W