Pharmacokinetics of levofloxacin following oral administration of a generic levofloxacin tablet and intravenous administration to dogs

Melanie Madsen 1Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Search for other papers by Melanie Madsen in
Current site
Google Scholar
PubMed
Close
 DVM
,
Kristen Messenger 1Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Search for other papers by Kristen Messenger in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
, and
Mark G. Papich 1Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606.

Search for other papers by Mark G. Papich in
Current site
Google Scholar
PubMed
Close
 DVM, MS

Abstract

OBJECTIVE

To determine the pharmacokinetics of levofloxacin following oral administration of a generic levofloxacin tablet and IV administration to dogs and whether the achieved plasma levofloxacin concentration would be sufficient to treat susceptible bacterial infections.

ANIMALS

6 healthy adult Beagles.

PROCEDURES

Levofloxacin was administered orally as a generic 250-mg tablet (mean dose, 23.7 mg/kg) or IV as a solution (15 mg/kg) to each dog in a crossover study design, with treatments separated by a minimum 2-day washout period. Blood samples were collected at various points for measurement of plasma levofloxacin concentration via high-pressure liquid chromatography. Pharmacokinetic analysis was performed with compartmental modeling.

RESULTS

After oral administration of the levofloxacin tablet, mean (coefficient of variation) peak plasma concentration was 15.5 μg/mL (23.8%), mean elimination half-life was 5.84 hours (20.0%), and mean bioavailability was 104% (29.0%). After IV administration, mean elimination half-life (coefficient of variation) was 6.23 hours (14.7%), systemic clearance was 145.0 mL/kg/h (22.2%), and volume of distribution was 1.19 L/kg (17.1%).

CONCLUSIONS AND CLINICAL RELEVANCE

In these dogs, levofloxacin was well absorbed when administered orally, and a dose of approximately 25 mg/kg was sufficient to reach pharmacokinetic-pharmacodynamic targets for treating infections with susceptible Enterobacteriaceae (ie, ≤ 0.5 μg/mL) or Pseudomonas aeruginosa (ie, ≤ 1 μg/mL) according to clinical breakpoints established by the Clinical and Laboratory Standards Institute.

Abstract

OBJECTIVE

To determine the pharmacokinetics of levofloxacin following oral administration of a generic levofloxacin tablet and IV administration to dogs and whether the achieved plasma levofloxacin concentration would be sufficient to treat susceptible bacterial infections.

ANIMALS

6 healthy adult Beagles.

PROCEDURES

Levofloxacin was administered orally as a generic 250-mg tablet (mean dose, 23.7 mg/kg) or IV as a solution (15 mg/kg) to each dog in a crossover study design, with treatments separated by a minimum 2-day washout period. Blood samples were collected at various points for measurement of plasma levofloxacin concentration via high-pressure liquid chromatography. Pharmacokinetic analysis was performed with compartmental modeling.

RESULTS

After oral administration of the levofloxacin tablet, mean (coefficient of variation) peak plasma concentration was 15.5 μg/mL (23.8%), mean elimination half-life was 5.84 hours (20.0%), and mean bioavailability was 104% (29.0%). After IV administration, mean elimination half-life (coefficient of variation) was 6.23 hours (14.7%), systemic clearance was 145.0 mL/kg/h (22.2%), and volume of distribution was 1.19 L/kg (17.1%).

CONCLUSIONS AND CLINICAL RELEVANCE

In these dogs, levofloxacin was well absorbed when administered orally, and a dose of approximately 25 mg/kg was sufficient to reach pharmacokinetic-pharmacodynamic targets for treating infections with susceptible Enterobacteriaceae (ie, ≤ 0.5 μg/mL) or Pseudomonas aeruginosa (ie, ≤ 1 μg/mL) according to clinical breakpoints established by the Clinical and Laboratory Standards Institute.

Contributor Notes

Dr. Madsen was a veterinary student at the time the study was performed.

Address correspondence to Dr. Papich (mark_papich@ncsu.edu).
  • 1. Papich MG. Ciprofloxacin pharmacokinetics and oral absorption of generic ciprofloxacin tablets in dogs. Am J Vet Res 2012;73:10851091.

  • 2. Papich MG. Ciprofloxacin pharmacokinetics in clinical canine patients. J Vet Intern Med 2017;31:15081513.

  • 3. Levaquin (levofloxacin) medication guide. Raritan, NJ: Ortho-McNeil-Jannsen Pharmaceuticals, 2008. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2008/021721s020_020635s57_020634s52_lbl.pdf. Accessed May 17, 2019.

    • Search Google Scholar
    • Export Citation
  • 4. Davis R, Bryson HM. Levofloxacin: a review of its antibacterial activity, pharmacokinetics and therapeutic efficacy. Drugs 1994;47:677700.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Eliopoulos GM. In vitro activity of fluoroquinolones against gram-positive bacteria. Drugs 1995;49(suppl 2):4857.

  • 6. Hecht DW, Wexler HM. In vitro susceptibility of anaerobes to quinolones in the United States. Clin Infect Dis 1996;23(suppl 1): S2S8.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Landoni MF, Albarellos GA. Pharmacokinetics of levofloxacin after single intravenous, oral and subcutaneous administration to dogs. J Vet Pharmacol Ther 2019;42:171178.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. CLSI. CLSI supplement M100. Performance standards for antimicrobial susceptibility testing. 29th ed. Wayne, Pa: CLSI, 2019.

  • 9. United States Pharmacopeia. Chapter 1225: validation of compendial procedures, USP 41–NF36. Rockville, Md: United States Pharmacopeial Convention, 2018.

    • Search Google Scholar
    • Export Citation
  • 10. Yin LF, Huang SJ, Jiang SG, et al. In vitro and in vivo evaluation of levofloxacin sustained-release capsules. Drug Dev Ind Pharm 2011;37:3340.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Fish DN, Chow AT. The clinical pharmacokinetics of levofloxacin. Clin Pharmacokinet 1997;32:101119.

  • 12. Papich MG. Chapter 37. Fluoroquinolone antimicrobial drugs. In: Riviere JE, Papich MG, eds. Veterinary pharmacology & therapeutics. 10th ed. Hoboken, NJ: Wiley Blackwell, 2018;953987.

    • Search Google Scholar
    • Export Citation
  • 13. Papich MG, Martinez MN. Applying biopharmaceutical classification system (BCS) criteria to predict oral absorption of drugs in dogs: challenges and pitfalls. AAPS J 2015;17:948964.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Heiene R, Eliassen KA, Ris⊘en U, et al. Glomerular filtration rate in dogs as estimated via plasma clearance of inulin and iohexol and use of limited-sample methods. Am J Vet Res 2010;71:11001107.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. CLSI. CLSI standard VET01. Performance standards for antimicrobial disk and dilution susceptibility tests for bacteria isolated from animals. 5th ed. Wayne, Pa: CLSI, 2018.

    • Search Google Scholar
    • Export Citation
  • 16. CLSI. VET08. Performance standards for antimicrobial disk and dilution susceptibility tests for bacteria isolated from animals. 4th ed. Wayne, Pa: CLSI, 2018.

    • Search Google Scholar
    • Export Citation
  • 17. CLSI. CLSI rationale document MR02. Fluoroquinolone breakpoints for Enterobacteriaceae and Pseudomonas aeruginosa. Wayne, Pa: CLSI, 2019.

    • Search Google Scholar
    • Export Citation

Advertisement