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How Long Levofloxacin Takes To Show Action On Lung Infection?

Posted on Mon, 5 May 2014

Question: If a culture-sensitivity test shows Levofloxacin has the best sensitivity to both types of bacterial infections ( Acinetobacter Baumannii and Stenotrophomonas Maltophilia) my father has in his lungs, is it unusual for it to take longer than 5 days to begin seeing improvement? He has been on the Levo (750 mg per day) for 5 days and just took his sixth dose. Thanks, XXXXXXX

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Brief answer...not unusual Detailed answer... Hello, Thanks for the query. Every antibiotic is different in how it works and how much time it takes to work.Although it takes couple of days for antibiotics to show result,in general,but some antibiotics may take several days to work. Levofloxacin is a fluoroquinolone antibacterial agent and distributes well and achieves high level of plasma concentrations in tissues of lungs,skin.prostate etc. In general,Levofloxacin is given for 7-14 days for the lung infections. Keep taking the antibiotic as prescribed and never leave it in the middle of course,of your own. I hope it helps,however you may revert to me for any further query. Best of luck Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (1 hour later)

Dr. XXXXXXX My Dad was given the Levofloxacin a month ago for pneumonia where they identified the type of bacteria which was sensitive to the Levo. He was feeling better by day 6. One week later, he started developing symptoms of pneumonia again but, the doctor prescribed him Cipro 500 mg. for 7 days. Another doctor prescribed him the Levo at 750 mg. for 14 days. My Dad stopped the cipro after day six and started on the Levo. I'm concerned as to what we need to do, and if we may have complicated his condition by switching from Levofloxacin to Cipro then back to Levofloxacin. What do you recommend he do, if he isn't feeling better in a few more days? His fever spikes are getting worse and he is getting no relief after 5 days. Thank you in advance, XXXXXXX

Answered by Dr. Pavan Kumar Gupta (1 hour later)

Hello, You are right.In fact LEVO shouldn't have been stopped midway earlier and there was no point of starting CIPRO. LEVO is much better drug for pneumonia as compared to CIPRO. Repeated switching of antibiotics along with inadequate doses results in resistance towards antibiotics. As you said correctly,wait for 3-4 days more and if there is still no resolution of his symptoms and fever keeps on spiking to same level,you must consult the doctor and possibly plan for culture and sensitivity test again. Don't stop the antibiotic now,till you get the sensitivity report. Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (6 hours later)

Thanks Doctor, At what point should he consider the Levo or other type of antibiotic (if no relief after 3-4 more days) with an I.V. into the vein? For every day he has fever above 100 degrees F, is another day of no hyperthermia and I.M.R.T. for his cancer. What are your thoughts on I.V. as opposed to 750 mg a day in pill form?

Answered by Dr. Pavan Kumar Gupta (8 minutes later)

Hello, Since LEVO can be taken orally then I/v route has no advantage over the oral route and hence oral route should be continued. The main point is whether the culture report is still in the favour of LEVO or not. If a fresh culture report still points towards LEVO as the best antibiotic,then it should be continued orally. I/v Antibiotics are given if either the patient is not able to take it orally or antibiotic is available only in injectable form and not oral form. Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (3 days later)

Doctor, The fever spikes have subsided. He now only has a low grade fever of 99.5 degrees F. His energy level is terrible.... he barely has enough energy to lay down and needs help getting up off of the couch. Could his Potassium or Magnesium levels be the cause of this? What can we do to increase his energy levels? I believe the Levo is beginning to work since the temperature is continuing to lower, however, I'm concerned about his energy and his appetite. He does not want to eat more than a few bites of food a day. What are your thoughts ? XXXXXXX

Answered by Dr. Pavan Kumar Gupta (24 minutes later)

Hello, Low energy is quite obvious after having fever for so many days. Longstanding fever results in dehydration which results in depletion of electrolytes like sodium and potassium. Take plenty of fluids,fruit juices,coconut water,multivitamins etc for low energy. Appetite shall return to normal gradually. Make sure to take the proper course of Levofloxacin and don't leave it in between. Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (9 hours later)

Update: My Dad has not seen a doctor in over a week. I believe I convinced him he needed to call a doctor; he did. He went to the emergency room for hydration treatment and blood work because that is what the medical team recommended. They took an x-ray of his lungs, the right lung doesn't look good - pneumonia... oxygen level is 80%. They took him off of the Levoflaxacin and put him on an I.V. drip of Ceftriaxone and an oral Sulfa drug. He is being transported via ambulance to another hospital where they have available beds. Thanks for your help.

Answered by Dr. Pavan Kumar Gupta (20 minutes later)

Hello, Oxygen saturation of 80% is not good and hence he definitely needs a proper management in the hospital. Wish your father best of luck and earliest recovery. Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar