Comparison of side effects of levofloxacin versus other fluoroquinolones

The side-effect profile of levofloxacin was compared with that of other flu oroquinolones based on European and international data from approximately 1 30 million prescriptions. Levofloxacin was found to be very safe with a low rate of hepatic abnormalities (1/650,000). In contrast, 140 trovafloxacin- treated patients developed hepatic problems, 14 of which were severe, and 8 required transplantation. The main CNS problems associated with fluoroquin olones include dizziness, convulsions, psychosis, and insomnia. Levofloxaci n, ofloxacin, and moxifloxacin reportedly have the lowest potential of indu cing central nervous system (CNS) adverse events among the fluoroquinolones currently available. Cardiovascular problems were seen in 1/15 million lev ofloxacin prescriptions compared to 1-3% of sparfloxacin patients having QT c prolongation of greater than 500 msec. Moxifloxacin was also associated w ith QTc prolongation when compared to non-fluoroquinolone comparators. Naus ea, vomiting, and diarrhoea remain the main adverse drug reactions (ADRs) a ssociated with levofloxacin. However, the ADR rate for levofloxacin is stil l one of the lowest of any fluoroquinolone at 2% (compared to 2-10% for oth er fluoroquinolones). Ofloxacin and levofloxacin have a very low phototoxic potential, whereas this is a problem for sparfloxacin, enoxacin, and peflo xacin. The tolerance profile of levofloxacin can be considered to be very g ood, and better than most, if not all of the fluoroquinolones available. Co pyright (C) 2001 S. Karger AG, Basel.