Table 3. Comparison and Summary of Case Reports in the Literature.
ALP: Alkaline phosphatase; AST: aspartate aminotransferase; ALT: alanine aminotransferase; WNL: within normal limits; RUQ: right upper quadrant; -: information not reported; BID: twice a day.
| Study Name | Levofloxacin Dosing Regimen | Total Daily Dose | Duration of Administration | Onset of Abnormal Lab Value (Days) | Peak ALT (<35 IU/L) | Peak AST (<35 IU/L) | Peak Bilirubin (0.3-1 mg/dL) | Peak ALP (30-120 IU/L) | Symptom Onset (Day) | Clinical Presentation | Resolution of Symptoms and/or Labs (Days) |
| Coban et al. 2005 [12] | 500 mg daily | 500 mg | 10 days | Day 2 | 937 | 1750 | 32.3 | 147 | Day 2 | Yellow sclerae, dark urine, severe fatigue, and malaise | No; death |
| Levine et al. 2014 [13] | 500 mg PO and IV daily | 500 mg | 74 days | - | 614 | 273 | 23.6 | 483 | Day 53 | Dark urine, jaundice, and hair loss | - |
| Spahr et al. 2001 [14] | 500 mg daily | 500 mg | 10 days | - | 4440 | 5000 | 3.67 | 157 | - | Jaundice, dark urine, abdominal discomfort, nausea and vomiting, dehydration | No; death |
| Karim et al. 2001 [15] | 500 mg daily | 500 mg | - | Day 2 | 7071 (Day 5) | 4962 (Day 5) | 2.5 (Day 7) | 90 (Day 16) | None | Yes; 1 week | |
| Carrascosa et al. 2009 [16] | 500 mg BID | 1000 mg | 5 days | - | 1577 (Day 10) | 1754 (Day 10) | 4 (Day 10) | 210 (Day 3) | Day 10 | Asthenia, jaundice, and dark urine | No; death |
| Titos-Arcos et al. 2011 [17] | 500 mg BID | 1000 mg | - | Day 5 | 52 (Day 7) | 58 (Day 5) | WNL | 1445 (Day 7) | - | - | Yes; 24 days |
| Figueira-Coehlo et al. 2010 [18] | 500 PO QD | 500 mg | 7 days | Day 7 | 953 (Day 13) | 329 (Day 13) | 1.6 (Day 2) | 141 (Day 28) | - | - | Yes; 2 weeks after 28 days of stay |
| Schwalm and Lee 2003 [19] | 250 mg PO Q24H | 250 mg | 21 days | - | 857 (Day 21) | 1392 (Day 21) | 4.09 (Day 21) | 423 (Day 21) | Day 21 | Confusion, drowsiness, RUQ tenderness | Yes; 1 week |
| Liccata et al. 2012 Case 1 [20] | 500 mg PO QD | 500 mg | 5 days | Day 5 | 400 | 370 | 0.6 | - | Day 5 | Nausea and hyperchromic urine, hepatomegaly | Yes; 2 weeks |
| Liccata et al. 2012 Case 2 [20] | IV (unknown dose) | - | - | Day 2 | 1129 | 587 | 0.45 | 225 | - | - | Yes; 1 month |
| Our Patient Case | Levofloxacin 500 mg PO daily | 500 mg | 7 days | Day 3 | 278 (Day 5) | 507 (Day 1) | 4.8 (Day 5-6) | 443 (Day 9) | 3 days | Abdominal pain, fevers, and altered mental status | - |