# Levofloxacin

Source: https://onco.cc/drugs/levofloxacin/  
OnCo record `levofloxacin` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Levofloxacin is an antibiotic. Children and adults expected to have very low white cell counts after chemotherapy may take it to prevent bacterial infection during that time.

## Summary

The US label covers pneumonia, skin, urinary, prostate and other infections, with boxed warnings about tendon, nerve and central nervous system effects. NICE CG151 offers adults with acute leukaemias, stem cell transplants or solid tumours in whom significant neutropenia (0.5 × 10⁹/L or lower) is expected prophylaxis with a fluoroquinolone during the expected period of neutropenia only, noting that in September 2024 only ciprofloxacin was licensed for this in the UK. The paediatric guideline endorsed by POGO and COG (2020) states that "Levofloxacin is the preferred agent if antibacterial prophylaxis is planned" (strong recommendation, moderate-quality evidence). The Levaquin NDA was approved on 20 December 1996.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: Levaquin / Tavanic
- Modality: Fluoroquinolone antibacterial (oral, intravenous)
- Mechanism: A fluoroquinolone that inhibits bacterial DNA gyrase and topoisomerase IV.
- Approvals: US 1996: Pneumonia, skin, urinary tract, prostate and other bacterial infections listed on the label

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Levofloxacin
- US label (DailyMed): levofloxacin tablets: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=05d179f5-b200-8597-e063-6394a90a10cc
- NICE CG151: Neutropenic sepsis, prevention and management in people with cancer, recommendations: https://www.nice.org.uk/guidance/cg151/chapter/Recommendations
- Lehrnbecher et al., Guideline for antibacterial prophylaxis administration in pediatric cancer and hematopoietic stem cell transplantation (Clin Infect Dis 2020): https://doi.org/10.1093/cid/ciz1082

## Connected records

- drugs: [Ciprofloxacin](https://onco.cc/drugs/ciprofloxacin/)
- terms: [Febrile neutropenia](https://onco.cc/terms/febrile-neutropenia/), [Neutropenia](https://onco.cc/terms/neutropenia/)

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