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A Review of Levofloxacin for the Treatment of Complicated Urinary Tract Infections and Acute Pyelonephritis

Jessina C. McGregor, PhD
George P. Allen, PharmD
David T. Bearden, PharmD

Oregon State University
College of Pharmacy,
Portland, Oregon, USA

Levofloxacin is a fluoroquinolone antibiotic approved for the treatment of complicated urinary tract infections (cUTIs) and acute pyelonephritis (AP). A comprehensive review of the medical literature identified five publications evaluating levofloxacin for the treatment of either cUTIs or AP. All trials, although variable in their inclusion criteria and levofloxacin dosing strategies, reported microbiologic, clinical, and safety related outcomes. High microbiologic eradication rates, ranging from 79.8% to 95.3%, were observed in the studies. Data regarding levofloxacin resistance, both at baseline and following therapy, was limited. Clinical success was observed to range from 82.6% to 93% when measured following the completion of therapy. These clinical and microbiologic results were comparable with the fluoroquinolone comparators in all trials. Levofloxacin was well tolerated in these studies, with headache, gastrointenstinal effects, and dizziness the most commonly reported adverse events. The published data support the use of levofloxacin in cUTI and AP. Further trials are necessary to evaluate levofloxacin within specific patient sub-populations.

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