Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Levofloxacin is an antibiotic for treating
bacterial infections. Many common infections in humans are caused by bacteria.
Bacteria can grow and multiply, infecting different parts of the body. Drugs
that control and eradicate these bacteria are called antibiotics. Levofloxacin
is an antibiotic that stops multiplication of bacteria by preventing the
reproduction and repair of their genetic material, DNA. It is in a class of
antibiotics called fluoroquinolones, a class that includes ciprofloxacin
(Cipro), norfloxacin (Noroxin), ofloxacin (Floxin),
trovafloxacin (Trovan), and
lomefloxacin (Maxaquin). The FDA approved levofloxacin in December 1996.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Tablets: 250, 500, and 750 mg; Oral solution: 25 mg/mL;
Injection: 5 mg/ml and 25 mg/ml
STORAGE: Levofloxacin should be stored between 15-30 C (59-86 F)
PRESCRIBED FOR: Levofloxacin is used to treat infections of the
sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible
bacteria. Levofloxacin also is frequently used to treat
urinary infections,
including those resistant to other antibiotics, as well as prostatitis
(infection of the prostate). Levofloxacin is effective in treating infectious
diarrhea caused by E. coli,
Campylobacter jejuni, and
Shigella bacteria.
Levofloxacin also can be used to treat various obstetric infections, including
mastitis (infection of the breast).
DOSING: The usual dose is 250-750 mg given once daily for 5-60 days
depending on the type of infection. It is important to take oral formulations at
least 2 hours before or 2 hours after any antacid or mineral supplement
containing iron, calcium, zinc, or magnesium since these bind levofloxacin and
prevent its absorption into the body.
DRUG INTERACTIONS: Iron, calcium, zinc, or magnesium can attach to
levofloxacin and other fluoroquinolones and prevent their absorption from the
intestine into the blood. Therefore, products (for example, antacids) that
contain iron, calcium, zinc or magnesium should be taken at least 2 hours before
or 2 hours after levofloxacin. Other drugs that contain these minerals and can
similarly interact with levofloxacin include sucralfate (Carafate) and
didanosine (Videx, Videx
EC).
Taking nonsteroidal antiinflammatory drugs (NSAIDs) with levofloxacin may
increase the risk of CNS stimulation, resulting in over-excitation. There have
been reports of changes in blood sugar (increases and decreases) in patients
treated with fluoroquinolones and antidiabetic agents. Fluoroquinolones may
increase blood levels of theophylline (Theodur), cyclosporine (Sandimmune,
Neoral), and the effect of warfarin (Coumadin).
PREGNANCY: Levofloxacin is not recommended for use in
pregnant women
since levofloxacin causes joint and bone deformities in juvenile animals of
several species.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Prostatitis is a painful condition of the prostate gland. There are four types of prostatitis, acute bacterial, chronic bacterial, chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Diagnosis is made with a digital rectal exam, urinalysis, ultrasound, MRI, biopsy, or blood test. Treatment depends upon the type of prostatitis.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Small intestinal bacterial overgrowth (SIBO) refers to a condition in which abnormally large numbers of bacteria (at least 100,000 bacteria per ml of fluid) are present in the small intestine and the types of bacteria in the small intestine resemble more the bacteria of the colon than the small intestine. There are many conditions associated with small intestinal bacterial overgrowth, to include: diabetes, scleroderma, Crohn's disease, and others. There is a striking similarity between the symptoms of irritable bowel syndrome and SIBO. It has been theorized that SIBO may be responsible for the symptoms of at least some patients with irritable bowel syndrome. Symptoms of SIBO include: excess gas, abdominal bloating, diarrhea, and abdominal pain.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Legionellosis is an infection caused by the Legionella pneumophila bacterium. There are two forms of legionellosis: Pontiac fever and Legionnaires' disease, which is the more severe of the two infections. Symptoms of Pontiac fever include fever, headache, muscle aches, and chills. Symptoms of Legionnaires' disease include cough, chills, fever and sometimes muscle aches, headaches, loss of appetite, diarrhea, and severe pneumonia. While Pontiac fever resolves on its own, Legionnaires' disease must be treated with antibiotics.
The urinary tract is comprised of the kidneys, ureters, bladder, and urethra
(see Figure 1). A urinary tract infection (UTI) is an infection caused by
pathogenic organisms (for example, bacteria, fungi, or parasites) in any of the
structures that comprise the urinary tract. However, this is the broad
definition of urinary tract infections; many authors prefer to use more specific
terms that localize the urinary tract infection to the major structural segment
involved such as urethritis (urethral infection),
cystitis (bladder infection),
ureter infection, and pyelonephritis (kidney infection). Other structures that
eventually connect to or share close anatomic proximity to the urinary tract
(for example, prostate, epididymis, and vagina) are sometimes included in the
discussion of UTIs because they may either cause or be caused by UTIs.
Technically, they are not UTIs and will be only briefly mentioned in this ...
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