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DOSAGE
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Bacterial conjunctivitis: Day 1-2: 1 or 2 gtts q2hrs while awake (up to 8 times per day) Days 3-7: 1 or 2 gtts q4hrs while awake (up to 4 times per day)
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INDICATIONS
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Levofloxacin ophthalmic solution is indicated for the treatment of bacterial conjunctivitis. Useful when ß-lactam and aminoglycoside resistance is encountered
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MECHANISM OF ACTION
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fluoroquinolone (3rd) Binds to DNA gyrase topoisomerase II or topoisomerase IV
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MICROBIOLOGY
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Levofloxacin has in vitro activity against a wide range of Gram-negative and Gram-positive microorganisms and is often bactericidal at concentrations equal to or slightly greater than inhibitory concentrations. Fluoroquinolones, including levofloxacin, differ in chemical structure and mode of action from β-lactam antibiotics and aminoglycosides, and therefore may be active against bacteria resistant to β-lactam antibiotics and aminoglycosides. Additionally, β-lactam antibiotics and aminoglycosides may be active against bacteria resistant to levofloxacin. Levofloxacin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section: Aerobic gram-positive microorganisms Corynebacterium species* Staphylococcus aureus Staphylococcus epidermidis Streptococcus pneumonia Streptococcus (Groups C/F) Streptococcus (Group G) Viridans group streptococci* Aerobic gram-negative microorganisms Acinetobacter lwoffii* Haemophilus influenzae Serratia marcescens* Levofloxacin exhibits in vitro minimal inhibitory concentrations (MICs) of 2 mcg/mL or less (systemic susceptible breakpoint) against most (≥ 90%) strains of the following ocular pathogens: Aerobic gram-positive microorganisms Enterococcus faecalis Staphylococcus saprophyticus Streptococcus agalactiae Streptococcus pyogenes Aerobic gram-negative microorganisms Acinetobacter anitratus Acinetobacter baumannii Citrobacter koseri Citrobacter freundii Enterobacter aerogenes Enterobacter agglomerans Enterobacter cloacae Escherichia coli Haemophilus parainfluenzae Klebsiella oxytoca Klebsiella pneumonia Legionella pneumophila Moraxella catarrhalis Morganella morganii Neisseria gonorrhoeae Proteus mirabilis Proteus vulgaris Providencia rettgeri Providencia stuartii Pseudomonas aeruginosa Pseudomonas fluorescens
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CONTRAINDICATIONS & WARNINGS
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Levofloxacin ophthalmic solution is contraindicated in patients with a history of hypersensitivity to levofloxacin, to other quinolones, or to any of the components in this medication.
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PEDIATRIC USE
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Safety and effectiveness in children below the age of six years have not been established.
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PREGNANCY
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Category C Teratogenic Effects: Levofloxacin at oral doses of 810 mg/kg/day in rats caused decreased fetal body weight and increased fetal mortality. No teratogenic effect was observed when rabbits were dosed orally as high as 50 mg/kg/day, at which systemic exposure was approximately 2,250 times that observed at the maximum recommended human ophthalmic dose, or when dosed intravenously as high as 25 mg/kg/day, at which systemic exposure was approximately 1000 times that observed at the maximum recommended human ophthalmic dose. There are, however, no adequate and well-controlled studies in pregnant women. Levofloxacin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
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