The drug should be prescribed to adults for the treatment of such infections: acute bacterial rhinosinusitis; exacerbation of chronic obstructive pulmonary disease, including bronchitis; non-hospital pneumonia; complicated skin and soft tissue infections; uncomplicated cystitis. For the above infections, the drug should be used only when it is considered inappropriate to use antibacterial drugs, which are usually recommended for the initial treatment of these infections. acute pyelonephritis and complicated urinary tract infections; chronic bacterial prostatitis;
active substance: levofloxacin;
1 tablet of “Levoflocin 250” contains levofloxacin hemihydrate in terms of levofloxacin 250 mg;
1 tablet of “Levoflocin 500” contains levofloxacin hemihydrate in terms of levofloxacin 500 mg;
Excipients: hydroxypropylcellulose, crospovidone, povidone, colloidal anhydrous silica, colloidal aqueous silicon dioxide, colloidal hydrophobic silicon dioxide, magnesium stearate, coating for coating Opadry II Yellow (iron oxides E 104, polyethylene, polyethylene talc, titanium dioxide E 171).
Levoflocin Dosage form
main physical and chemical properties: round tablets, with a biconvex surface, coated with a yellow film, “Levoflocin 250” – without a dash, “Levoflocin 500” – with a dash.
Levoflocin Pharmacotherapeutic group
Antibacterial agents of the quinolone group. Fluoroquinolones. ATX code J01M A12.
Levoflocin Pharmacological properties
The drug has a wide range of antimicrobial action. Rapid bactericidal effect is provided due to inhibition by levofloxacin of the bacterial enzyme DNA gyrase, which belongs to type II topoisomerases. As a result, the volumetric structure of the DNA of bacteria is disrupted and their division is blocked.
The spectrum of activity of levofloxacin includes the following microorganisms.
Gram-positive aerobes: Enterococcus faecalis, Staphylococcus aureus methi-S, Staphylococcus haemolyticus methi-S, Staphylococcus saprophyticus, Streptococci group C, G, Streptococcus agalactiae, Streptococcus pneumoniae penige Seni – S /.
Gram-negative aerobes: Acinetobacter baumannii, Citrobacter freundii, Eikenella corrodens, Enterobacter agglomerans, Enterobacter cloacae, Escherichia coli, Haemophilus influenzae ampi-S / R, Haemophilus para-influenzae, Klebsiella morxalalia, Klebsiella oxytola, Moria Pasteurella multocida, Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, Pseudomonas aeruginosa, Serratia marcescens.
Anaerobes: Bacteroides fragilis, Clostridium perfringens, Peptostreptococcus.
Others: Chlamydia pneumoniae, Chlamydia psittaci, Legionella pneumophila, Mycoplasma pneumoniae, Ureaplasma, H. pylori.
The following are constantly sensitive to the drug:
gram-positive aerobes: Stphylococcus haemolyticus methi-R;
gram-negative aerobes: Burkholderia cepacia;
anaerobes: Bacteroides ovatus, Bacteroides thetaiiotamicron, Bacteroides vulgaris, Clostridium difficile.
Resistant to the drug:
gram-positive aerobes: Staphylococcus aureus methi – R.
Like other fluoroquinolones, levofloxacin is inactive against spirochetes.
Species that may become resistant
Gram-positive aerobes: Enterococcus faecalis, Staphylococcus aureus methicillin-sensitive, coagulase-negative Staphylococcus spp.
Gram-negative aerobes: Acinetobacter baumannii, Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, Providencia stuartii, Pseudomonas aerucescea, Serrati.
Anaerobes: Bacteroides fragilis.
Naturally resistant strains
Gram-positive aerobes: Enterococcus faecium.
Mechanism of resistance development
Resistance to levofloxacin develops as a stepwise mutation of the target site in both types of topoisomerase II, DNA gyrase and topoisomerase IV. Other mechanisms of resistance, such as permeability (characteristic of Pseudomonas aeruginosa), and outflow mechanisms may also affect sensitivity to levofloxacin.
There is cross-resistance between levofloxacin and other fluoroquinolones. Due to the mechanism of action, there is no cross-resistance between levofloxacin and other classes of antibacterial agents.