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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does Levaquin React With Bactrim And Keflex?

can I safely take levaquin, bactriim ds and Keflex all together? I have a uti caused by pseudomonas and almost completely knocked it out after a week on Keflex and Bactrim ds. then the results of the c + s came back and showed that the infection is responsive to levaquin. I ve started the levaquin but I m hesitant to stop the other two antibiotics because they almost completely knocked out the infection. I shall be grateful for your advice. Robert wilbur
Tue, 23 Feb 2016
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Internal Medicine Specialist,  's  Response
Hello,

it would be an unusual choice of regimen...

First of all keflex is not active against pseudomonas, so there is no reason to take it. Bactrim is not a great choice against pseudomonas but I guess it worked OK in your case. Levaquin may be active against pseudomonas but ciprofloxacin is usually preferable.

One important point is the decision to treat or not. If you had no symptoms then there is no need to receive treatment unless you're about to undergo an invasive procedure in your urinary tract. If you had symptoms then a fluoroquinolone (if Pseusomonas is not resistant) should be fine. Taking them both (levaquin and bactrim DS) may increase the risk for cardiological complications although the absolute risk would be low.

So in conclusion, I suggest taking a fluoroquinolone alone if you had symptoms and the antibiogram indicates that Pseudomonas is sensitive to them. I would also suggest the higher doses for Pseudomonas (750mg once daily for levaquin or 750mg twice a day for ciprofloxacin).

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
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Does Levaquin React With Bactrim And Keflex?

Hello, it would be an unusual choice of regimen... First of all keflex is not active against pseudomonas, so there is no reason to take it. Bactrim is not a great choice against pseudomonas but I guess it worked OK in your case. Levaquin may be active against pseudomonas but ciprofloxacin is usually preferable. One important point is the decision to treat or not. If you had no symptoms then there is no need to receive treatment unless you re about to undergo an invasive procedure in your urinary tract. If you had symptoms then a fluoroquinolone (if Pseusomonas is not resistant) should be fine. Taking them both (levaquin and bactrim DS) may increase the risk for cardiological complications although the absolute risk would be low. So in conclusion, I suggest taking a fluoroquinolone alone if you had symptoms and the antibiogram indicates that Pseudomonas is sensitive to them. I would also suggest the higher doses for Pseudomonas (750mg once daily for levaquin or 750mg twice a day for ciprofloxacin). I hope you find my comments helpful! You can contact me again, if you d like any clarification or further information. Kind Regards!