Levofloxacin
| Evidence Level: L5 | Predicted Indications: 9 |
Table of Contents
Levofloxacin: Punctate epithelial keratoconjunctivitis
One-Sentence Summary
Levofloxacin is a broad-spectrum fluoroquinolone antibacterial that is marketed in India as single-ingredient oral tablets. The TxGNN model predicts it may be useful for punctate epithelial keratoconjunctivitis, with a score of 0.9992. Evidence is very thin: 0 clinical trials and 1 publication (an outbreak report that does not test levofloxacin).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not recorded in the local data |
| Predicted New Indication | Punctate epithelial keratoconjunctivitis |
| TxGNN Prediction Score | 0.9992 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data |
| Number of Listed Products | at least 20 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available in the data compiled for this report. Based on its drug class, levofloxacin is a fluoroquinolone that kills bacteria by inhibiting bacterial DNA replication enzymes. Because it works against a broad range of bacteria, applying it to infections of the ocular surface is plausible.
The only retrieved paper is a report of a microsporidial keratoconjunctivitis outbreak linked to swimming-pool water in Taiwan. Microsporidia are intracellular, fungi-related organisms that fluoroquinolones do not reliably treat. The paper therefore gives no support for efficacy.
The very high TxGNN score most likely reflects the model’s closeness to other eye-surface infection and inflammation conditions, not direct evidence. The prediction should be treated as a hypothesis only.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 30055152 | 2018 | Outbreak report | American Journal of Ophthalmology | Microsporidial keratoconjunctivitis outbreak tied to contaminated swimming-pool water in Taiwan. It does not evaluate levofloxacin treatment. |
India Market Information
The record may be partial. Five of the valid single-ingredient licences are shown.
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 122062 | Lquin 750 Tablet (Cipla Ltd) | Strip of 5 tablets | Not stated |
| 192687 | R-Levo 250 Tablet (R.B. Remedies Pvt Ltd) | Strip of 10 tablets | Not stated |
| 11175 | Avulox 500mg Tablet (Avunu Life Sciences) | Strip of 10 tablets | Not stated |
| 128899 | Livopen 250mg Tablet (Morepen Laboratories Ltd) | Strip of 10 tablets | Not stated |
| 82302 | Elvox 500mg Tablet (Elder Pharmaceuticals Ltd) | Strip of 5 tablets | Not stated |
All listed products are oral tablets. No topical or ophthalmic formulation appears in the local records, which matters for an ocular surface indication.
Safety Considerations
- Drug Interactions: 434 interactions are recorded. Major-level examples include tramadol and hydrocortisone. Moderate-level examples include metformin, pioglitazone, alogliptin, ibuprofen, ketorolac, famotidine, ethinylestradiol, salbutamol, formoterol and adenosine.
- Conditions flagged for caution (not taken from label text): long QT syndrome and torsades de pointes, epilepsy, liver disease and drug-induced liver injury, tendinitis, peripheral neuropathy, myasthenia gravis, diabetes (including ketoacidosis), impaired renal function, rhabdomyolysis, Clostridium difficile colitis, and several blood-count disorders (thrombocytopenia, leukopenia, anemia, pancytopenia).
Please also refer to the package insert for full safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The evidence level is L5. The only paper concerns a microsporidial outbreak, a cause fluoroquinolones are not expected to treat, and no trial tests levofloxacin for this condition. The high score alone does not justify moving forward.
To proceed, the following is needed:
- Evidence that links levofloxacin to bacterial causes of punctate epithelial keratoconjunctivitis, such as clinical or microbiological studies
- Detailed mechanism of action data
- A route-compatibility assessment, since only oral tablets are recorded locally and no ocular formulation is listed
- Package insert warnings and contraindications to complete the safety screen
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.