Levonadifloxacin
Drug Class
Novel Benzoquinolizine Fluoroquinolone antibiotic
Available as
Levonadifloxacin – Intravenous
Alalevonadifloxacin – Oral prodrug
Mechanism of Action
- Inhibits bacterial DNA gyrase (primary target), resulting in inhibition of DNA replication and bacterial cell death.
- Unlike conventional fluoroquinolones, it preferentially targets DNA gyrase rather than topoisomerase IV, providing potent activity against MRSA and quinolone-resistant Staphylococcus aureus.
- Retains activity in acidic environments, intracellular infections, and biofilms.
Indications
- Acute Bacterial Skin and Skin Structure Infections (ABSSSI)
- Diabetic Foot Infections
- Community-Acquired Bacterial Pneumonia (CAP)
- Hospital-acquired respiratory infections
Spectrum of activity
Active Against
Gram-positive: MRSA, MSSA, hVISA, VRSA, Streptococcus pneumoniae, Streptococcus pyogenes.
Gram-negative: E. coli, Klebsiella pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, Acinetobacter baumannii.
Atypical pathogens: Mycoplasma, Chlamydophila, Legionella, Ureaplasma.
Anaerobes: Clostridium spp., Bacteroides fragilis, Prevotella, Porphyromonas.
Recommended Dose
IV Levonadifloxacin- 800 mg IV every 12 hours
Oral Alalevonadifloxacin- 1000 mg orally every 12 hours
Dose Adjustment
Renal impairment: Pharmacokinetic studies in renal impaired patients have not been conducted.
Hepatic impairment: No dose adjustment required, including Child-Pugh A, B and C patients.
Contraindications
- Hypersensitivity to levonadifloxacin, alalevonadifloxacin, or other quinolone antibiotics.
- Avoid in patients with previous serious fluoroquinolone-associated adverse reactions
Special Population
Pregnancy: Use only if clearly needed; avoid routine use due to limited human safety data.
Breastfeeding: Use with caution; consider temporary interruption of breastfeeding if clinically indicated due to insufficient human data.
