The Way Forward: High-Dose, Short-Course Levofloxacin Leads the Field

29 March, 2018

Question 12

The lower 500 mg dose has been useful in providing easy switch from IV to PO therapy. Does the high-dose regimen also provide a convenient transition from IV to PO therapy and what benefits in clinical management does this option provide? 

The 750 mg levofloxacin dose retains the pharmacologic features that allow easy switching from IV to PO therapy as well as promoting faster resolution of fever. These features, coupled with the IDSA guidelines recommending parenteral therapy be maintained in CAP patients until they have been afebrile for 48 hours, result in high-dose levofloxacin providing a cost-effective strategy in terms of an earlier switch from IV to PO therapy thereby ultimately enabling patients to be discharged from hospital sooner, a feature that is not necessarily found with the other fluoroquinolones such as ciprofloxacin.