Clinical Applications of Levofloxacin for Severe Infections

New fluoroquinolones, as exemplified by levofloxacin, possess broad spectrum activity against many common pathogens, including the majority responsible for respiratory tract infections (RTIs), atypical pathogens and those resistant to other therapeutic regimens. Following administration, levofloxacin attains high intracellular and tissue levels. This, coupled with an exceptional pharmacodynamic profile, allows levofloxacin to be administered once daily. However, in certain circumstances, such as seriously ill patients or those with difficult-to-treat pathogens, higher doses may be required. Since the bactericidal effect of levofloxacin is concentration-dependent, it is possible to increase peak concentration by increasing the dose, resulting in even better tissue concentration (and a possible reduction in the development of resistance). High-dose levofloxacin is able to exploit these pharmacokinetic features to provide an effective treatment for severe infections. Data is now available confirming the efficacy of high-dose levofloxacin in a wide range of infections, including nosocomial pneumonia, meningitis and complicated skin and skin structure infections (CSSSIs). Not only is this regimen effective, it is also well tolerated and provides the physician with an additional therapeutic option to manage critically ill patients.