Levofloxacin is an antibiotic drug that was first marketed in Japan in 1992 and in subsequent years in Europe and the United States. The substance achieves its effect by inhibiting the enzyme gyrase, which is derived from infectious bacteria. In preparations, levofloxacin is used to combat bacterial infections of the gastrointestinal tract, respiratory tract, and ear, nose, and throat.
What is levofloxacin?
The active ingredient levofloxacin is classified as part of the fluoroquinolone group, which also includes the closely related agent ofloxacin. Also part of this group of antibiotics are moxifloxacin and ciprofloxacin. Levofloxacin was first approved as a drug in Japan in 1992. Further approvals followed in the USA in 1996 and then in Germany (1998). Levofloxacin is used as an antibiotic to treat bacterial infections affecting the gastrointestinal tract, prostate, respiratory tract or ear, nose and throat. The drug achieves its effectiveness by inhibiting the enzyme gyrase, which is derived from the DNA of the infectious bacteria. Levofloxacin is described in chemistry with the molecular formula C 18 – H 20 – F – N 3 – O 4 and has a moral mass of 361.37 g/mol. The slightly yellowish powder is usually administered as a film-coated tablet and taken orally. It is also available as an infusion solution.
Pharmacologic Action
The mechanism of action of levofloxacin is bactericidal. This means that the drug kills bacteria. The pharmacologic action on the targeted bacterium is typical of representatives of the fluoroquinolones through inhibition of the enzyme gyrase. This inhibits the spatial orientation of DNA molecules and is of immense importance for the viability of a bacterium, as it is responsible for the so-called DNA supercoiling of a bacterium. Medical literature reports that levofloxacin has a particularly high efficacy against the bacteria Moraxella catarrhalis and Haemophilus influenzae, a trigger of various respiratory infections. Chlamydia and pneumococcus are also very sensitive to levofloxacin, so the pharmacological effect is extremely high. Long-term use of levofloxacin should be avoided, if possible, because the active ingredient can also stress human organs in the long term.
Medical use and application
Levofloxacin is processed into broad-spectrum and reserve antibiotics. It is prescribed to treat mild to moderate bacterial infections in adults if caused by levofloxacin-susceptible bacteria. These include:
Complicated urinary tract infections, inflammation of the respiratory tract such as bronchitis or pneumonia (lung inflammation), inflammation of the nasal sinuses (acute bacterial sinusitis), infections of the skin and subcutaneous (soft) tissues, including muscles, and ultimately prolonged infections of the prostate (prostate gland). Thus, the area of application of levofloxacin largely corresponds to that of the closely related active ingredient ofloxacin. The applicability in inflammation of the lungs (pneummonia) results from the fact that the drug substance levofloxacin has a higher antibacterial effect compared to ofloxacin. Levofloxacin is usually administered as a film-coated tablet and taken orally. Treatment by infusion may also be indicated, particularly in more severe disease.
Risks and side effects
Like all antibiotics, levofloxacin can cause side effects. However, these do not occur with all treatments. Before taking it for the first time, check whether there is an intolerance. In this case, levofloxacin must not be administered. This is also the case if an allergy to other quinolo antibiotics (e.g. ofloxacin, moxifloxacin or ciprofloxacin) is known, an epilepsy disorder is present, tendon complications have already occurred during treatment with quinolo antibiotics (e.g. tendonitis), pregnancy is known or breastfeeding is taking place. Treatment of children and adolescents is also not usually given. In medical studies, the following adverse reactions have been associated with treatment with levofloxacin:
- Occasionally (in less than one in 100 people treated): itching and skin rash, stomach upset or digestive disturbances, loss of appetite, general feeling of weakness, change in the number of white blood cells in the blood, headache, nervousness, sleep problems, dizziness, and drowsiness.
- Rarely (in less than one in 1,000 people treated): tingling in the hands and feet without adequate external causation (paresthesia), tremor, anxiety, feelings of restlessness and stress, depression, increase in heart rate, breathing problems or whistling breathing (bronchospasm), or shortness of breath (dyspnea).
- Very rarely (in less than one in 10,000 people treated): drop in blood sugar levels (hypoglycemia), hearing or vision disturbances, increased sensitivity to light, disturbances in the sense of smell and taste, circulatory arrest, fever, and a persistent feeling of being sick.
