Question 8

What dose and duration of levofloxacin therapy do you recommend?

The most commonly used dose of levofloxacin is 500 mg once daily, which has been effective for most RTI including CAP and sinusitis. In addition, there is a 750 mg dose that is effective for more serious RTI such as patients with pneumonia that requires hospitalization. The higher dose formulation also allows physicians to treat for 5 days rather than the 10 days used for 500 mg. When deciding on treatment regimens, I assess the patient and, if they are relatively healthy and compliant, I tend to use the high-dose, short-course levofloxacin regimen because it provides less overall drug exposure with a similar side-effect profile. However, the regimens used in other countries depend on local guidelines. One of the advantages of the 750 mg 5-day levofloxacin course is that most patients take antibiotics when feeling sick and then stop them as they improve. The 5-day course matches the duration of therapy to the course of symptoms.