Левофлоксацин Таблетки, коробка, 5 шт, 500 мг, для приема внутрь

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На поперечном разрезе ядро от белого до светло-желтого цвета."}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\n\nЛевофлоксацин – синтетический антибактериальный препарат широкого спектра действия из группы фторхинолонов, содержащий в качестве активного вещества левофлоксацин - левовращающий изомер офлоксацина. Блокирует ДНК-гиразу (топоизомеразу II) и топоизомеразу IV, нарушает суперспирализацию и сшивку разрывов ДНК, ингибирует синтез ДНК, вызывает глубокие морфологические изменения в цитоплазме, клеточной стенке и мембранах чувствительных микроорганизмов."}},{"type":"paragraph","data":{"text":"Левофлоксацин активен в отношении большинства штаммов микроорганизмов, как в условиях in vitro, так и in vivo."}},{"type":"paragraph","data":{"text":"In vitro"}},{"type":"paragraph","data":{"text":"Чувствительные микроорганизмы (МПК ≤ 2 мг/л; зона ингибирования ≥ 17 мм)"}},{"type":"paragraph","data":{"text":"-Аэробные грамположительные микроорганизмы: Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium jeikeium, Enterococcus spp. , Enterococcus faecalis, Listeria monocytogenes, Staphylococcus coagulase-negative"}},{"type":"paragraph","data":{"text":"methi-S(I) [коагулазонегативные метициллин-чувствительные/-умеренно чувствительные, Staphylococcus aureus methi-S (метициллин-чувствительные), Staphylococcus epidermidis methi-S (метициллин-чувствительные), Staphylococcus spp. CNS (коагулазонегативные), Streptococci u G, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus pneumonia peni I/S/R (пенициллин- умерено чувствительные/-чувствительные/-резистентные), Viridans streptococci peni-S/R ( пенициллин-чувствительные/-резистентные)."}},{"type":"paragraph","data":{"text":"-Аэробные грамотрицательные микроорганизмы: Acinetobacter baumanii, Acinetobacter spp., Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenza ampi-S/R (ампициллин- чувствительные/-резистентные), Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella spp., Moraxela catarrhalis β+/β- (продуцирующие и непродуцирующие бета-лактамазы), Morganella morganii, Neisseria gonorrhoeae non PPNG/PPNG (не продуцирующие и продуцирующие пенициллиназу), Neisseria meningitidis, Pasteurella canis, Pasteurella dagmatis, Pasteurella multocida Pasteurella spp., Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii Providencia spp. Pseudomonas aeruginosa (госпитальные инфекции, вызванные Pseudomonas aeruginosa, могут потребовать комбинированного лечения), Pseudomonas spp., Salmonella spp., Serratia marcescens, Serratia spp."}},{"type":"paragraph","data":{"text":"-Анаэробные микроорганизмы: Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus, Propionibacterium spp., Veilonella spp."}},{"type":"paragraph","data":{"text":"-Другие микроорганизмы: Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp., Mycobacterium spp., Mycobacterium leprae, Mycobacterium tuberculosis, Mycoplasma hominis, Mycoplasma pneumoniae, Rickettsia spp. , Ureaplasma urealyticum."}},{"type":"paragraph","data":{"text":"Умеренно чувствительные микроорганизмы (МПК = 4 мг/л; зона ингибирования 16-14 мм)"}},{"type":"paragraph","data":{"text":"-Аэробные грамположительные микроорганизмы: Corynebacterium urealyticum, Corynebacterium xerosis, Enterococcus faecium, Staphylococcus epidermidis methi-R(метициллин-резистентные), Staphylococcus haemolyticus methi-R (метициллин-резистентные)."}},{"type":"paragraph","data":{"text":"-Аэробные грамотрицательные микроорганизмы: Campylobacter jejuni/coli."}},{"type":"paragraph","data":{"text":"-Анаэробные микроорганизмы: Prevotella spp., Porphyromonas spp."}},{"type":"paragraph","data":{"text":"Резистентные к левофлоксацину микроорганизмы (МПК > 8мг/л; зона ингибирования < 13 мм)"}},{"type":"paragraph","data":{"text":"-Аэробные грамположительные микроорганизмы: Staphylococcus aureus methi-R (метициллин-резистентные), Staphylococcus coagulase-negative methi-R (коагулазонегативные метициллин-резистентные)."}},{"type":"paragraph","data":{"text":"-Аэробные грамотрицательные микроорганизмы: Alcaligenes xylosoxidans."}},{"type":"paragraph","data":{"text":"-Анаэробные микроорганизмы: Bacteroides thetaiotaomicron."}},{"type":"paragraph","data":{"text":"-Другие микроорганизмы: Mycobacterium avium."}},{"type":"paragraph","data":{"text":"Резистентность"}},{"type":"paragraph","data":{"text":"Резистентность к левофлоксацину развивается в результате поэтапного процесса мутаций генов, кодирующих обе топоизомеразы типа II: ДНК-гиразу и топоизомеразу IV. Другие механизмы резистентности, такие как механизм влияния на пенетрационные барьеры микробной клетки (механизм, характерный для Pseudomonas aeruginosa) и механизм эффлюкса (активного выведения противомикробного средства из микробной клетки), могут также уменьшать чувствительность микроорганизмов к левофлоксацину."}},{"type":"paragraph","data":{"text":"В связи с особенностями механизма действия левофлоксацина обычно не наблюдается перекрестной резистентности между левофлоксацином и другими противомикробными средствами."}},{"type":"paragraph","data":{"text":"Клиническая эффективность (эффективность в клинических исследованиях при лечении инфекций, вызываемых перечисленными ниже микроорганизмами):"}},{"type":"paragraph","data":{"text":"-Аэробные грамположительные микроорганизмы: Enterococcus faecalis, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes."}},{"type":"paragraph","data":{"text":"-Аэробные грамотрицательные микроорганизмы: Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Haemophilus influenzaemophilus parainfluenzae, Klebsiella pneumoniae, Moraxella (Branhamella) catarrhalis, Morganella morganii, Proteus mirabilis, Pseudomonas aeruginosa, Serratia marcescens."}},{"type":"paragraph","data":{"text":"-Другие: Chlamydia pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae\n\n"}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"\n\nЛечение инфекционно-воспалительных заболеваний, вызванных чувствительными к левофлоксацину микроорганизмами:"}},{"type":"paragraph","data":{"text":"- внебольничная пневмония;"}},{"type":"paragraph","data":{"text":"- госпитальная пневмония (для дозировки 750 мг);"}},{"type":"paragraph","data":{"text":"- осложненные инфекции мочевыводящих путей и пиелонефрит;"}},{"type":"paragraph","data":{"text":"- хронический бактериальный простатит;"}},{"type":"paragraph","data":{"text":"- инфекции кожных покровов и мягких тканей;"}},{"type":"paragraph","data":{"text":"- для комплексного лечения лекарственно-устойчивых форм туберкулеза;"}},{"type":"paragraph","data":{"text":"- профилактика и лечение сибирской язвы при воздушно-капельном пути заражения."}},{"type":"paragraph","data":{"text":"Для лечения следующих инфекционно-воспалительных заболеваний левофлоксацин может применяться только в качестве альтернативы другим противомикробным препаратам:"}},{"type":"paragraph","data":{"text":"- острый синусит;"}},{"type":"paragraph","data":{"text":"- обострение хронического бронхита;"}},{"type":"paragraph","data":{"text":"- неосложненный цистит."}},{"type":"paragraph","data":{"text":"При применении препарата Левофлоксацин следует учитывать официальные национальные рекомендации по надлежащему применению антибактериальных средств, а также чувствительность патогенных микроорганизмов в конкретной стране (см.раздел «Особые указания»).\n\n"}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n\nПовышенная чувствительность к левофлоксацину или к другим хинолонам, а также к любому из вспомогательных веществ препарата;"}},{"type":"paragraph","data":{"text":"эпилепсия;"}},{"type":"paragraph","data":{"text":"поражения сухожилий при применении фторхинолонов в анамнезе; псевдопаралитическая миастения (myasthenia gravis);"}},{"type":"paragraph","data":{"text":"детский и подростковый возраст до 18 лет (в связи с незавершенностью роста скелета, так как нельзя полностью исключить риск поражения хрящевых точек роста); беременность (нельзя полностью исключить риск поражения хрящевых зон роста у плода);"}},{"type":"paragraph","data":{"text":"период грудного вскармливания (нельзя полностью исключить риск поражения хрящевых точек роста костей у ребенка)."}},{"type":"paragraph","data":{"text":"Ввиду отсутствия возможности деления таблетки надвое противопоказано применение препарата у пациентов с нарушениями функции почек:"}},{"type":"paragraph","data":{"text":"- у пациентов с клиренсом креатинина менее 50 мл/мин при режиме дозирования с первоначальной дозой 250 мг/ 24 ч;"}},{"type":"paragraph","data":{"text":"- у пациентов с клиренсом кретинина менее 20 мл/мин при режиме дозирования с первоначальной дозой 500 мг/24 ч и 500 мг/12 ч.\n\n"}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- У пациентов, предрасположенных к развитию судорог [у пациентов с предшествующими поражениями центральной нервной системы (ЦНС), у пациентов, одновременно получающих препараты, снижающие порог судорожной готовности головного мозга, такие как фенбуфен, теофиллин] (см. раздел «Взаимодействие с другими лекарственный средствами»)."}},{"type":"paragraph","data":{"text":"- У пациентов с латентным или манифестированным дефицитом глюкозо-6- фосфатдегидрогеназы (повышенный риск гемолитических реакций при лечении хинолонами)."}},{"type":"paragraph","data":{"text":"- У пациентов с нарушением функции почек с клиренсом креатинина 50-20 мл/мин (также см. раздел «Противопоказания»)."}},{"type":"paragraph","data":{"text":"- У пациентов с известными факторами риска удлинения интервала QT: у пациентов пожилого возраста; у пациентов женского пола; у пациентов с нескорректированными электролитными нарушениями (с гипокалиемией, гипомагниемией); с синдромом врожденного удлинения интервала QT; c заболеваниями сердца (сердечная недостаточность, инфаркт миокарда, брадикардия); при одновременном приеме лекарственных препаратов, способных удлинять интервал QT (антиаритмические средства класса IA и III, трициклические антидепрессанты, макролиды, нейролептики) (см. разделы «Передозировка», «Взаимодействие с другими лекарственными средствами», «Особые указания»)."}},{"type":"paragraph","data":{"text":"- У пациентов с сахарным диабетом, получающих пероральные гипогликемические препараты, например, глибенкламид или препараты инсулина (возрастает риск гипогликемии)."}},{"type":"paragraph","data":{"text":"- У пациентов с тяжелыми нежелательными реакциями на другие фторхинолоны, такими как тяжелые неврологические реакции (повышенный риск возникновения аналогичных нежелательных реакций при применении левофлоксацина)."}},{"type":"paragraph","data":{"text":"- У пациентов с психозами или у пациентов, имеющих в анамнезе психические заболевания (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"- У пациентов пожилого возраста, у пациентов после трансплантации, а также при сопутствующем применении глюкокортикостероидов (повышенный риск развития тендинитов и разрыва сухожилий).\n\n"}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Левофлоксацин противопоказан для применения у беременных и кормящих грудью женщин."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nТаблетки препарата Левофлоксацин 250 мг, 500 мг или 750 мг принимают внутрь один или два раза в сутки. Таблетки следует проглатывать, не разжевывая и запивая достаточным количеством жидкости (от 0,5 до 1 стакана)."}},{"type":"paragraph","data":{"text":"Препарат можно принимать перед едой или в любое время между приемами пищи, так как прием пищи не влияет на абсорбцию препарата (см. раздел «Фармакокинетика»)."}},{"type":"paragraph","data":{"text":"Препарат следует принимать не менее чем через 2 часа до или через 2 часа после приема препаратов, содержащих магний и/или алюминий, железо, цинк или сукральфат (см. раздел «Взаимодействие с другими лекарственными средствами»)."}},{"type":"paragraph","data":{"text":"Учитывая то, что биодоступность левофлоксацина при приеме в таблетках равна 99-100 %, в случае перевода пациента с внутривенной инфузии левофлоксацина на прием таблеток следует продолжать лечение в той же дозе, которая применялась при внутривенной инфузии (см. раздел «Фармакокинетика»)."}},{"type":"paragraph","data":{"text":"Пропуск приема одной или нескольких доз препарата"}},{"type":"paragraph","data":{"text":"Если случайно пропущен прием препарата, то надо, как можно скорее, принять очередную дозу и далее продолжать принимать препарат согласно рекомендованному режиму его дозирования."}},{"type":"paragraph","data":{"text":"Дозы и продолжительность лечения"}},{"type":"paragraph","data":{"text":"Режим дозирования определяется характером и тяжестью инфекции, a также чувствительностью предполагаемого возбудителя. Продолжительность лечения варьирует в зависимости от течения заболевания."}},{"type":"paragraph","data":{"text":"Рекомендуемый режим дозирования и продолжительность лечения у пациентов с нормальной функцией почек (КК > 50 мл/мин)"}},{"type":"paragraph","data":{"text":"- Внебольничная пневмония: по 2 таблетки 250 мг или по 1 таблетке 500 мг 1-2 раза в сутки (соответственно по 500-1000 мг левофлоксацина) -7–14 дней."}},{"type":"paragraph","data":{"text":"Внебольничная пневмония, вызванная Streptococcus pneumoniae (пенициллин-умеренно чувствительные/-чувствительные/-резистентные), Haemophilus influenza, Haemophilus parainfluenzae, Mycoplasma pneumoniae, Chlamydia pneumoniae, - по 1 таблетке 750 мг 1 раз в сутки – 5 дней."}},{"type":"paragraph","data":{"text":"- Госпитальная пневмония: по 1 таблетке 750 мг 1 раз в сутки - 7-14 дней."}},{"type":"paragraph","data":{"text":"- Осложнённые инфекции мочевыводящих путей: по 2 таблетки 250 мг 1 раз в сутки или по 1 таблетке 500 мг 1 раз в сутки (соответственно по 500 мг левофлоксацина) - 7-14 дней."}},{"type":"paragraph","data":{"text":"При лечении осложненных инфекций мочевыводящих путей, вызванных Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, и острого пиелонефрита, вызванного Escherichia coli, включая случаи с сопутствующей бактериемией, - по 1 таблетке 750 мг 1 раз в сутки 5 дней."}},{"type":"paragraph","data":{"text":"- Пиелонефрит: по 2 таблетки 250 мг 1 раз в сутки или по 1 таблетке 500 мг 1 раз в сутки (соответственно по 500 мг левофлоксацина) - 7-10 дней."}},{"type":"paragraph","data":{"text":"- Хронический бактериальный простатит: по 2 таблетки 250 мг или по 1 таблетке 500 мг 1 раз в сутки (соответственно по 500 мг левофлоксацина) - 28 дней."}},{"type":"paragraph","data":{"text":"- Инфекции кожных покровов и мягких тканей: по 2 таблетки 250 мг или по 1 таблетке 500 мг 1-2 раза в сутки (соответственно по 500-1000 мг левофлоксацина) - 7-14 дней. При осложненных инфекциях кожных покровов и мягких тканей: по 1 таблетке 750 мг 1 раз в сутки - 10-14 дней."}},{"type":"paragraph","data":{"text":"- Комплексное лечение лекарственно-устойчивых форм туберкулеза: по 1 таблетке 500 мг 1-2 раза в сутки (соответственно по 500-1000 мг левофлоксацина) - до 3-х месяцев."}},{"type":"paragraph","data":{"text":"- Профилактика и лечение сибирской язвы при воздушно-капельном пути заражения: по 2 таблетки 250 мг или по 1 таблетке 500 мг (соответственно по 500 мг левофлоксацина) 1 раз в сутки в течение до 8 недель."}},{"type":"paragraph","data":{"text":"- Острый синусит: по 2 таблетки 250 мг или по 1 таблетке 500 мг 1 раз в сутки (соответственно по 500 мг левофлоксацина) - 10-14 дней; по 1 таблетке 750 мг 1 раз в сутки - 5 дней."}},{"type":"paragraph","data":{"text":"- Обострение хронического бронхита: по 2 таблетки 250 мг или по 1 таблетке 500 мг 1 раз в сутки (соответственно по 500 мг левофлоксацина) - 7-10 дней."}},{"type":"paragraph","data":{"text":"- Неосложнённые цистит: по 1 таблетке 250 мг 1 раз в сутки (соответственно по 250 мг левофлоксацина) - 3 дня."}},{"type":"paragraph","data":{"text":"Режим дозирования у пациентов с нарушением функции почек (КК ≤50 мл/мин)"}},{"type":"paragraph","data":{"text":"Левофлоксацин выводится преимущественно почками, поэтому при лечении пациентов с нарушенной функцией почек требуется снижение дозы препарата.Режим дозирования у пациентов с нарушениями функции печени"}},{"type":"paragraph","data":{"text":"При нарушении функции печени не требуется коррекция режима дозирования, поскольку левофлоксацин лишь незначительно метаболизируется в печени ."}},{"type":"paragraph","data":{"text":"Режим дозирования у пациентов пожилого возраста"}},{"type":"paragraph","data":{"text":"Для пациентов пожилого возраста не требуется коррекции режима дозирования, за исключением случаев снижения КК до 50 мл/мин и ниже.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nС осторожностью применяют левофлоксацин пациентам пожилого возраста (высокая вероятность наличия сопутствующего снижения функции почек)."}},{"type":"paragraph","data":{"text":"После нормализации температуры рекомендуется продолжать лечение не менее 48-78 ч. Длительность в/в вливания 500 мг (100 мл инфузиоиного раствора) должна составлять не менее 60 мин. Во время лечения необходимо избегать солнечного и искусственного УФ облучения во избежание повреждения кожных покровов (фотосенсибилизация). При появлении признаков тендинита левофлоксацин немедленно отменяют. Следует иметь в виду, что у больных с поражением головного мозга в анамнезе (инсульт, тяжелая травма) возможно развитие судорог, при недостаточности глюкoзo-6-фосфатдeгидpoгeназы - риск развития гемолиза."}},{"type":"paragraph","data":{"text":"Влияние на способность к вождению автотранспорта и управлению механизмами"}},{"type":"paragraph","data":{"text":"В период лечения необходимо воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.\n\n"}}]}],"source":null},"description_toggle":false,"short_description":"Левофлоксацин – синтетический антибактериальный препарат широкого спектра действия из группы фторхинолонов, содержащий в качестве активного вещества левофлоксацин - левовращающий изомер офлоксацина. Блокирует ДНК-гиразу (топоизомеразу II) и топоизомеразу IV, нарушает суперспирализацию и сшивку разрывов ДНК, ингибирует синтез ДНК, вызывает глубокие морфологические изменения в цитоплазме, клеточной стенке и мембранах чувствительных микроорганизмов. Левофлоксацин активен в отношении большинства штаммов микроорганизмов, как в условиях in vitro, так и in vivo. In vitro Чувствительные микроорганизмы (МПК ≤ 2 мг/л; зона ингибирования ≥ 17 мм) -Аэробные грамположительные микроорганизмы: Bacillus anthracis, Corynebacterium diphtheriae, Corynebacterium jeikeium, Enterococcus spp. , Enterococcus faecalis, Listeria monocytogenes, Staphylococcus coagulase-negative methi-S(I) [коагулазонегативные метициллин-чувствительные/-умеренно чувствительные, Staphylococcus aureus methi-S (метициллин-чувствительные), Staphylococcus epidermidis methi-S (метициллин-чувствительные), Staphylococcus spp. CNS (коагулазонегативные), Streptococci u G, Streptococcus agalactiae, Streptococcus pyogenes, Streptococcus pneumonia peni I/S/R (пенициллин- умерено чувствительные/-чувствительные/-резистентные), Viridans streptococci peni-S/R ( пенициллин-чувствительные/-резистентные). -Аэробные грамотрицательные микроорганизмы: Acinetobacter baumanii, Acinetobacter spp., Actinobacillus actinomycetemcomitans, Citrobacter freundii, Eikenella corrodens, Enterobacter aerogenes, Enterobacter cloacae, Enterobacter spp., Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenza ampi-S/R (ампициллин- чувствительные/-резистентные), Haemophilus parainfluenzae, Helicobacter pylori, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella spp., Moraxela catarrhalis β+/β- (продуцирующие и непродуцирующие бета-лактамазы), Morganella morganii, Neisseria gonorrhoeae non PPNG/PPNG (не продуцирующие и продуцирующие пенициллиназу), Neisseria meningitidis, Pasteurella canis, Pasteurella dagmatis, Pasteurella multocida Pasteurella spp., Proteus mirabilis, Proteus vulgaris, Providencia rettgeri, Providencia stuartii Providencia spp. Pseudomonas aeruginosa (госпитальные инфекции, вызванные Pseudomonas aeruginosa, могут потребовать комбинированного лечения), Pseudomonas spp., Salmonella spp., Serratia marcescens, Serratia spp. -Анаэробные микроорганизмы: Bacteroides fragilis, Bifidobacterium spp., Clostridium perfringens, Fusobacterium spp., Peptostreptococcus, Propionibacterium spp., Veilonella spp. -Другие микроорганизмы: Bartonella spp., Chlamydia pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, Legionella pneumophila, Legionella spp., Mycobacterium spp., Mycobacterium leprae, Mycobacterium tuberculosis, Mycoplasma hominis, Mycoplasma pneumoniae, Rickettsia spp. , Ureaplasma urealyticum. Умеренно чувствительные микроорганизмы (МПК = 4 мг/л; зона ингибирования 16-14 мм) -Аэробные грамположительные микроорганизмы: Corynebacterium urealyticum, Corynebacterium xerosis, Enterococcus faecium, Staphylococcus epidermidis methi-R(метициллин-резистентные), Staphylococcus haemolyticus methi-R (метициллин-резистентные). -Аэробные грамотрицательные микроорганизмы: Campylobacter jejuni/coli. -Анаэробные микроорганизмы: Prevotella spp., Porphyromonas spp. Резистентные к левофлоксацину микроорганизмы (МПК \u003e 8мг/л; зона ингибирования\u003c13 мм) -Аэробные грамположительные микроорганизмы: Staphylococcus aureus methi-R (метициллин-резистентные), Staphylococcus coagulase-negative methi-R (коагулазонегативные метициллин-резистентные). -Аэробные грамотрицательные микроорганизмы: Alcaligenes xylosoxidans. -Анаэробные микроорганизмы: Bacteroides thetaiotaomicron. -Другие микроорганизмы: Mycobacterium avium. Резистентность Резистентность к левофлоксацину развивается в результате поэтапного процесса мутаций генов, кодирующих обе топоизомеразы типа II: ДНК-гиразу и топоизомеразу IV. Другие механизмы резистентности, такие как механизм влияния на пенетрационные барьеры микробной клетки (механизм, характерный для Pseudomonas aeruginosa) и механизм эффлюкса (активного выведения противомикробного средства из микробной клетки), могут также уменьшать чувствительность микроорганизмов к левофлоксацину. В связи с особенностями механизма действия левофлоксацина обычно не наблюдается перекрестной резистентности между левофлоксацином и другими противомикробными средствами. 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