Q25. Some Asian physicians believe that they should use slightly lower doses because patients in Asia tend to be smaller. Do you have any data or would you still recommend the 500 mg dose of levofloxacin for preventive treatment and the 750 mg for active treatment in Asian patients?
Summary: The optimal dose of levofloxacin in febrile neutropenia depends on the individual clinical situation. When administered prophylactically, levofloxacin is effective and beneficial using a 500 mg once-daily dose. When treating suspected or confirmed febrile neutropenia, it is likely that a 750 mg dose would be beneficial over the previously used 500 mg dose. This higher dose is recommended as it is based on the concentration-dependent killing associated with fluoroquinolones, achieving higher tissue concentrations and subsequently better outcomes and a more rapid resolution of infection.