II. Precautions

  1. QT Prolongation with Levofloxacin (Levaquin)
    1. Three fold increased risk of Sudden Cardiac Death while on Levofloxacin
    2. This appears to be a class effect with most Fluoroquinolones except Ciprofloxacin
    3. Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]

III. Activity Spectrum

  1. Gram Negative Rod coverage (see other Fluoroquinolones)
    1. Enterobacteriaceae
  2. Atypical Bacteria
  3. Moderate Gram Positive activity

IV. Indications

  1. Community Acquired Pneumonia
  2. Refractory acute Bacterial Sinusitis (third line agent)

V. Preparations

  1. Levofloxacin (Levaquin)
  2. Moxifloxacin (Avelox)
    1. Low urine concentrations (avoid in UTI)
    2. No Pseudomonas coverage
    3. Highest risk Quinolone for QT Prolongation
  3. Sparfloxacin (Zagam)
    1. Low urine concentrations (avoid in UTI)
  4. Gatifloxacin (Tequin)
    1. Removed from U.S. market in 2006 due to fatalities (Hypoglycemia related)

VI. Adverse Effects

  1. See Fluoroquinolone
  2. Hypoglycemia with Gatifloxacin (Tequin)
    1. Has occurred in non-diabetics
    2. Contraindicated in Diabetes Mellitus

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

levofloxacin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
LEVOFLOXACIN 0.5% EYE DROPS Generic $5.69 per ml
LEVOFLOXACIN 25 MG/ML SOLUTION Generic $0.94 per ml
LEVOFLOXACIN 250 MG TABLET Generic $0.18 each
LEVOFLOXACIN 500 MG TABLET Generic $0.20 each
LEVOFLOXACIN 750 MG TABLET Generic $0.43 each
gatifloxacin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
GATIFLOXACIN 0.5% EYE DROPS Generic $28.53 per ml
moxifloxacin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
MOXIFLOXACIN HCL 400 MG TABLET Generic $5.53 each
avelox (on 10/12/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
AVELOX 400 MG TABLET Generic $5.53 each