Lquin: Advanced Fluoroquinolone Therapy for Severe Bacterial Infections
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Lquin (levofloxacin) is a broad-spectrum fluoroquinolone antibiotic designed for the targeted treatment of complicated and resistant bacterial infections. As a third-generation antimicrobial agent, it offers enhanced gram-positive and atypical pathogen coverage while maintaining potent activity against gram-negative organisms. Its optimized pharmacokinetic profile ensures high tissue penetration and reliable bactericidal concentration at infection sites. Clinically indicated for conditions including community-acquired pneumonia, acute bacterial sinusitis, and complicated urinary tract infections, Lquin represents a critical tool in modern anti-infective therapy where first-line treatments have proven inadequate or inappropriate.
Features
- Contains 250mg, 500mg, or 750mg of levofloxacin per tablet
- Bioavailability exceeding 99% with minimal food interference
- Dual excretion pathway: renal (87%) and hepatic (14%)
- Plasma half-life of 6–8 hours permitting once-daily dosing
- Broad spectrum coverage including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus (methicillin-susceptible), and Enterobacteriaceae
- Available in both oral and intravenous formulations for sequential therapy
Benefits
- Rapid bactericidal action achieving clinical improvement within 48–72 hours in most indications
- Superior lung tissue penetration (2:1 tissue-to-plasma ratio) ensuring effective respiratory infection management
- Reduced risk of resistance development compared to earlier fluoroquinolones due to dual-target inhibition
- Convenient once-daily dosing improves patient compliance and reduces treatment abandonment
- Demonstrated efficacy in immunocompromised patients and those with comorbidities
- Cost-effective alternative to combination antibiotic regimens with similar coverage
Common use
Lquin is predominantly prescribed for adult patients presenting with moderate to severe bacterial infections where pathogen susceptibility testing or epidemiological data support its use. Primary indications include community-acquired pneumonia (including multidrug-resistant Streptococcus pneumoniae), complicated urinary tract infections (pyelonephritis), acute bacterial exacerbations of chronic bronchitis, and skin and skin structure infections. Off-label use may include prosthetic joint infections, chronic bacterial prostatitis, and certain gastrointestinal infections when tailored to culture results. It is particularly valuable in cases where beta-lactam antibiotics are contraindicated due to allergy or confirmed resistance patterns.
Dosage and direction
Standard dosing for most indications is 500mg orally or intravenously once daily for 7–14 days. For complicated urinary tract infections or acute pyelonephritis, 750mg once daily for 5 days is recommended. Dosage adjustment is mandatory in renal impairment:
- CrCl ≥50 mL/min: No adjustment
- CrCl 20–49 mL/min: 250mg initial dose, then 250mg q24h
- CrCl 10–19 mL/min: 250mg initial dose, then 250mg q48h
- Hemodialysis: 250mg initial dose, then 250mg q48h (administer after dialysis)
Administration should occur at least 2 hours before or 2 hours after antacids, sucralfate, or metal cations (iron, zinc). Tablets should be swallowed whole with water, without crushing or chewing. IV infusion should be administered over 60 minutes for 250mg or 500mg doses, and 90 minutes for 750mg doses.
Precautions
Patients should maintain adequate hydration to prevent crystal formation. Avoid prolonged sun exposure and use protective measures due to photosensitivity risk. Blood glucose monitoring is advised in diabetic patients due to potential hypoglycemia/hyperglycemia. Neurological status should be monitored for signs of peripheral neuropathy. Tendon rupture risk increases in patients over 60, those taking corticosteroids, or with history of organ transplantation. ECG monitoring is recommended in patients with known QT prolongation risk factors.
Contraindications
Absolute contraindications include known hypersensitivity to levofloxacin or other quinolones, history of tendon disorders associated with quinolone use, and concurrent administration with tizanidine. Relative contraindications include pre-existing QT prolongation, uncorrected hypokalemia, significant bradycardia, and patients with known glucose-6-phosphate dehydrogenase deficiency. Not recommended in pediatric patients (except for inhalational anthrax), during pregnancy (Category C), or nursing mothers due to arthropathy risk in developing joints.
Possible side effect
Common reactions (≥1% incidence) include nausea (3.5%), diarrhea (1.7%), headache (1.6%), and insomnia (1.3%). Less frequent but clinically significant effects include tendonitis (0.2%), peripheral neuropathy (0.3%), QT prolongation (0.4%), and phototoxicity (0.6%). Rare events (<0.1%) include hepatic enzyme elevation, pseudomembranous colitis, blood dyscrasias, and severe hypersensitivity reactions. Psychiatric effects such as anxiety, confusion, or depression may occur particularly in elderly patients.
Drug interaction
Significant interactions occur with:
- Antacids, sucralfate, iron preparations: Reduced absorption (separate by 2+ hours)
- Warfarin: Increased INR monitoring required (potential PT prolongation)
- NSAIDs: Increased CNS excitation risk
- Antiarrhythmics (Class IA, III): Additive QT prolongation
- Glibenclamide: Enhanced hypoglycemic effect
- Theophylline: Increased serum concentrations possible
- Corticosteroids: Elevated tendon rupture risk
Missed dose
If a dose is missed, administer as soon as remembered unless less than 8 hours remain until the next scheduled dose. Do not double the next dose to compensate. Maintain consistent 24-hour intervals between doses to ensure stable serum concentrations. Patients should be advised to set daily reminders and maintain dosing consistency, particularly given the concentration-dependent killing mechanism of fluoroquinolones.
Overdose
Symptoms may include altered mental status, nausea, vomiting, QT prolongation, seizures, or renal impairment. Management is supportive with ECG monitoring for至少 24 hours. Hemodialysis removes approximately 10% of circulating drug over 4 hours. No specific antidote exists. Gut decontamination with activated charcoal may be beneficial if administered within 2 hours of ingestion. Maintain adequate hydration and renal function monitoring for至少 72 hours post-overdose.
Storage
Store tablets at controlled room temperature (15°–30°C/59°–86°F) in original container protected from light and moisture. Do not freeze. Keep IV solution in overwrap until use and protect from light. Reconstituted solutions are stable for 72 hours at room temperature or 14 days refrigerated. Discard any unused portion after single use. Keep out of reach of children and pets.
Disclaimer
This information does not replace professional medical advice. Prescription requires thorough assessment of infection type, pathogen susceptibility, and patient-specific factors. Healthcare providers must weigh benefits against risks, particularly regarding tendon, neuropsychiatric, and cardiovascular effects. Resistance surveillance data should guide empirical use. Not all side effects or interactions are listed; report adverse events to appropriate regulatory authorities.
Reviews
Clinical trials demonstrate clinical cure rates of 92–96% for respiratory infections and 88–93% for urinary tract infections. Meta-analyses show superiority to macrolides in pneumococcal pneumonia and comparable efficacy to ceftriaxone in complicated UTIs. Post-marketing surveillance indicates satisfactory tolerability profile though with noted attention to tendon and CNS effects. Many infectious disease specialists value its reliability in community settings where resistance patterns preclude first-line agents. Long-term safety data continue to be collected through ongoing pharmacovigilance programs.