What is the efficacy of levofloxacin and ofloxacin in intravenous-to-oral switch therapy?

Updated: Jul 30, 2018
  • Author: Shirin A Mazumder, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Answer

In 2005, Pablos et al reported on a study of the consumption of quinolones (eg, ofloxacin, levofloxacin, ciprofloxacin) 6 months before and after the implementation of a sequential therapy program in hospitalized patients. A program was calculated for each antibiotic, in its oral and intravenous forms, in "defined daily dose/100 stays per day" and in economic terms (drug acquisition cost). At the beginning of the program, ofloxacin was replaced by levofloxacin and, because their clinical uses are similar, the consumption of both drugs was compared during the period. [27]

In economic terms, the consumption of intravenous quinolones decreased 60%, whereas the consumption of oral quinolones increased 66%. In "defined daily dose/100 stays per day," consumption of intravenous forms decreased 53% and consumption of oral forms increased 36%. Pablos et al focused on quinolones and their use in implementing a sequential therapy program based on promoting an early switch from an intravenous regimen to an oral regimen. They proved the program's capacity to alter the use profile of these antibiotics. During the period under consideration, the program achieved a global drug savings of $41,420 for the hospital. [27]

Levofloxacin (Levaquin) has activity against pneumococci, including penicillin-resistant isolates, and activity against aerobic gram-negative rods but not Pseudomonas. It can be used to treat CAP. The adult dose is 500 mg PO qd for 7-14 d. It is not recommended for children. Levofloxacin is a pregnancy category C medication.

Ofloxacin (Floxin) penetrates the prostate well and is effective against Chlamydia trachomatis. It is derived from pyridine carboxylic acid and has broad-spectrum bactericidal effect. It is specifically used to treat prostatitis and UTI. In adults, the dosing for prostatitis is 400 mg PO once, while dosing for chronic prostatitis is 200-400 mg PO q12h. It is not recommended for children. Ofloxacin is also a pregnancy category C medication.


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