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Nosocomial Pneumonia in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Levofloxacin is a respiratory quinolone is active against P. aeruginosa. Levofloxacin has few side effects. Ciprofloxacin is associated with seizures and should not be used in patients with seizure disorders or central nervous system disorders. In contrast to ciprofloxacin, the use of levofloxacin has not been associated with resistance problems with respect to S. pneumoniae, P. aeruginosa, or other organisms. Levofloxacin does not predispose to MRSA colonization, as is the case with ciprofloxacin. Levofloxacin does not lower seizure potential or cause seizures vs. ciprofloxacin. If a fluoroquinolone is selected as part of a combination regimen against P. aeruginosa, levofloxacin is the preferred quinolone for this purpose [2,31].
Anti-Infective Agents
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The pregnancy experience in humans suggests low risk; however, the authors of one study recommended avoid giving Levofloxacin during pregnancy because safer alternatives are generally available. However, fluoroquinolones are commonly avoided in the perinatal period because of fears from fetal cartilage damage.
Hydrolytic Enzymes for the Synthesis of Pharmaceuticals
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2019
Sergio González-Granda, Vicente Gotor-Fernández
Levofloxacin is a potent fluoroquinolone antibacterial agent used in the treatment of pneumonia, sinusitis or urinary tract infections among others. Rhizomucor miehei lipase (RML) has been efficiently applied in the hydrolysis of racemic 1-(2,3-difluoro-6-nitrophenoxy)propan-2-yl acetate, (Scheme 9.8), leading to the formation of the enantiopure (R)-alcohol in 45% yield and the remaining (R)-acetate in 84% ee after 53 h at 30°C (López-Iglesias et al., 2015). Alternatively, the same alcohol and the homologue amine have been produced in higher-yielding processes starting from prochiral ketones through bioreduction or biotransamination experiments, respectively (Mourelle-Insua et al., 2016). RML-catalysed hydrolysis of a racemic ester for the production of a Levofloxacin precursor.
Ameliorative effects of Moringa oleifera leaf extract on levofloxacin-induced hepatic toxicity in rats
Published in Drug and Chemical Toxicology, 2020
Ayman Samir Farid, Ahmed Medhat Hegazy
Levofloxacin is a third-generation fluoroquinolone antibiotic. It has broad-spectrum activity against Gram-positive and Gram-negative bacteria as well as certain other pathogens such as Mycobacteria spp., Mycoplasma, Chlamydia, and Legionella (Fish and Chow 1997). The effectiveness of Levofloxacin against infections of the respiratory tract, skin and genitourinary tract has been demonstrated (Croom and Goa 2003). Levofloxacin triple therapy containing Levofloxacin, a proton pump inhibitor, and amoxicillin has been effective for the treatment of Helicobacter pylori infection for more than 10 years (Malfertheiner et al.2012, Nista et al.2003). Levofloxacin and other fluoroquinolones produce serious adverse effects more frequently than other broad-spectrum antibacterial drugs (Stahlmann and Lode 2013). The most common side effects are abdominal pain, diarrhea, vomiting, nausea, dizziness, and rash (Ceydilek et al.2005). Hepatotoxicity, phototoxicity, cardiotoxicity, and central nervous system side effects are less frequent. Increases in liver function tests and liver failure (Ceydilek et al. 2005, Gulen et al.2015, Yagawa 2001) are mentioned.
Corneal melting in a case undergoing treatment with pembrolizumab
Published in Clinical and Experimental Optometry, 2020
Chang‐chi Weng, Chih‐chiau Wu, Pei‐yu Lin
Bilateral simultaneous corneal melting manifest in this patient looked similar to that occurring in SS, paracentral keratolysis in rheumatoid arthritis or keratopathy due to erlotinib which she did not have before.2012 Although she had received cisplatin and etoposide, she did not have corneal surface disease or corneal melting in the past two years. The last chemotherapy was given five months before the first cycle of pembrolizumab, so it was less likely that the corneal melting was related to the chemotherapy or combining radiotherapy. The appearance of corneal melt in this patient was different from that of typical peripheral ulcerative keratitis. The lesion was at the mid‐periphery instead of juxtalimbal; the shape of the melt was oval instead of crescent, with the long axis vertical to instead of parallel with the limbus. In addition, the patient did not meet the diagnostic criteria for rheumatoid arthritis, granulomatosis with polyangiitis or relapsing polychondritis. The lesion was bilateral with characteristics less likely to be infectious keratitis, although a corneal scrape for culture was not performed because the patient suffered from severe dyspnoea. The use of topical levofloxacin was for prevention of secondary infection.
A retrospective analysis of infections and antibiotic treatment in patients with Stevens–Johnson syndrome and toxic epidermal necrolysis
Published in Journal of Dermatological Treatment, 2020
Min Diao, Christina Thapa, Xin Ran, Yuping Ran, Xiaoyan Lv
In our study, patients with pulmonary infections but without skin infections were frequently prescribed macrolides, lincomycin, and carbapenems. It is possible that these patients were treated with macrolides and lincomycin to control community-acquired pneumonia upon admission to the hospital (13). Then, their antibiotic regimens may have been adjusted to carbapenems when they developed secondary hospital-acquired pneumonia, which is most commonly caused by gram-negative bacilli (14). Patients with skin infections but without pulmonary infections were commonly administered macrolides, lincomycin, vancomycin, and quinolones. Staphylococcus was the most common organism causing skin infections, so clindamycin was prescribed to those patients who were allergic to penicillin. Levofloxacin and moxifloxacin are both effective against gram-positive and gram-negative bacteria and are frequently used as broad-spectrum antibiotics in patients with skin infections. However, some patients who had severe conditions or had repeatedly used antibiotics outside the hospital were administered vancomycin due to suspicion of methicillin-resistant S. aureus (MRSA). Patients with simultaneous combined pulmonary and skin infections had more serious infections. They were commonly given potent antibiotics, such as vancomycin and carbapenems, followed by antifungal agents.