Levofloxacin is an advanced generation fluoroquinolone antibiotic, marketed by Ortho-McNeil under the trade name Levaquin in the United States. In Europe, it is marketed by Sanofi-Aventis under the trade name Tavanic, in Chile as Gatigol by Alpes Selection, and in Asia it is marketed by Daiichi under the trade name Cravit. Levofloxacin was launched in the Japanese market in 1993, and thus has had more than 13 years of testing in efficiency and safety globally. Chemically, levofloxacin is the S-enantiomer (L-isomer) of ofloxacin, and has approximately twice the potency of ofloxacin. It works by inhibiting DNA gyrase, an enzyme that negatively supercoils DNA.

Levofloxacin is effective against a number of gram-positive and gram-negative bacteria. Because of its broad spectrum of action, levofloxacin is frequently prescribed empirically for a wide range of infections (e.g. pneumonia, urinary tract infection) before the specific causal organism is known. If the causal organism is identified, levofloxacin may be discontinued and the patient may be switched to an antibiotic with a narrower spectrum of activity. Levofloxacin is currently the only respiratory fluoroquinolone approved by the U.S. FDA for the treatment of nosocomial pneumonia.

Susceptible organisms

Gram-positive bacteria

Enterococcus faecalis (many strains are only moderately susceptible)
Staphylococcus aureus (methicillin-susceptible strains)
Staphylococcus epidermidis (methicillin-susceptible strains)
Staphylococcus saprophyticus
Streptococcus pneumoniae (including Multidrug-resistant strains, MDRSP)
Streptococcus pyogenes

Gram-negative bacteria

Enterobacter cloacae
Klebsiella pneumoniae
Pseudomonas aeruginosa
Escherichia coli
Legionella pneumophila
Serratia marcescens
Haemophilus influenzae
Moraxella catarrhalis
Haemophilus parainfluenzae
Proteus mirabilis
Campylobacter

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