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Levofloxacin IV Shortage

July 25 , 2017

The Issue:

Levofloxacin 250 mg/50 mL, 500 mg/100 mL, and 750 mg/150 mL minibags are available in limited supply. The 250 mg minibags are expected to be available mid-September 2017 and the 500 mg and 750 mg minibags in late November 2017 without restriction.

Current stock levels are low and the limited supply may not meet current demand.

Key messages include: 

  • Physicians should be aware of the shortage of IV levofloxacin.
  • Suggested strategies to manage the shortage:
    • Ensure that patients who can take oral/NG medications are initiated/switched to oral levofloxacin wherever possible as the bioavailability is close to 100% with the oral formulation.
    • The following therapeutic interchange is approved in Covenant Health so pharmacists can also make this change as appropriate.
  • Alternatives vary depending on the clinical indication and may include: 
    • Ceftriaxone + azithromycin for patients hospitalized with community-acquiredManags
    • Amoxicillin-clavulanate, cefuroxime axetil, or doxycycline for other respiratory tract infections where oral therapy is appropriate (check Bugs & Drugs for further details).
    • Moxifloxacin 400mg IV is non-formulary (NF) in Covenant Health hospitals but can be used during this back order if a respiratory IV quinoline is required. (NF process and therapeutic interchange to levofloxacin +/- metronidazole will not apply during this back order period). Moxifloxacin is also on back order but may be still available at some sites until stock is depleted. 

Action: 
Please post this notice in your area and ensure all staff is informed about the change.

Contact: 
Please contact your site pharmacy department with any questions or concerns.

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