Evo 500

Indications for Use

Evo is prescribed for treating a range of infections caused by specific microorganisms. It is effective for:

• Acute Maxillary Sinusitis: Effective against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
• Acute Bacterial Exacerbation of Chronic Bronchitis: Targets Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
• Community-Acquired Pneumonia: Suitable for infections caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae.
• Uncomplicated and Complicated Urinary Tract Infections: Effective against Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.
• Acute Pyelonephritis: Effective against Escherichia coli.
• Uncomplicated and Complicated Skin and Soft Tissue Infections: Treats abscesses, cellulitis, furuncles, impetigo, pyoderma, and wound infections caused by Staphylococcus aureus, Streptococcus pyogenes, Proteus mirabilis, and Enterococcus faecalis.
• Enteric Infections: Effective for infections caused by Enterobacter species, Escherichia coli, Campylobacter species, Vibrio cholerae, Shigella species, and Salmonella species.

Product Description

Evo is a broad-spectrum, third-generation fluoroquinolone antibiotic designed for oral administration. It is a chiral fluorinated carboxyquinolone, specifically levofloxacin.

Pharmacological Information

Levofloxacin, a third-generation fluoroquinolone, exhibits antibacterial properties by inhibiting bacterial topoisomerase IV and DNA gyrase—key enzymes involved in DNA replication, repair, and recombination. It has a broad in vitro activity spectrum against both Gram-negative and Gram-positive bacteria.

Dosage Instructions

• Oral Tablets:
  • 250 mg, 500 mg, or 750 mg once daily.
  • Can be taken with or without food. For the oral solution, take it 1 hour before or 2 hours after meals.
• Intravenous Injection:
  • Administered by slow infusion only.
  • 250 mg or 500 mg infused over 60 minutes, or 750 mg over 90 minutes, every 24 hours.
  • Discard any unused portion. Do not mix with other solutions or medications in the same line.

Dosage Guidelines

• Adults:
  • Acute Sinusitis: 500 mg daily for 10-14 days or 750 mg daily for 5 days.
  • Exacerbation of Chronic Bronchitis: 500 mg daily for 7 days or 750 mg daily for 3 days (uncomplicated), 5 days (complicated).
  • Community-Acquired Pneumonia: 500 mg daily for 7-14 days or 750 mg daily for 5 days.
  • Uncomplicated Urinary Tract Infections: 250 mg daily for 3 days.
  • Complicated Urinary Tract Infections & Acute Pyelonephritis: 250 mg daily for 7-10 days.
  • Uncomplicated Skin and Soft Tissue Infections: 500 mg daily for 7-10 days.
  • Complicated Skin and Soft Tissue Infections: 750 mg daily for 7-14 days.
  • Enteric Fever: 500 mg daily for 7-14 days.
  • Diarrhea, Cholera, Shigellosis & Enteritis: Mild to moderate cases: 500 mg single dose; moderate to severe cases: 500 mg daily for 3 days.
• Children:
  • 6 months to <5 years: 10 mg/kg every 12 hours.
  • >5 years: 10 mg/kg daily.

Sequential therapy (switching from intravenous to oral) may be considered based on clinical judgment.

Administration Guidelines

• Levofloxacin Infusion:
  • Inspect the container for leaks or cloudiness before use.
  • Do not use if solution is not clear or has precipitates.
  • Administer only through a slow intravenous infusion. Avoid using flexible containers in series connections.
  • Follow proper administration steps to ensure effective delivery.

Interactions

• Avoid co-administration with solutions containing multivalent cations (e.g., magnesium).
• Antacids, iron, and adsorbents can reduce absorption.
• NSAIDs may increase the risk of central nervous system stimulation.
• Warfarin may elevate bleeding risk.

Contraindications

Levofloxacin is contraindicated in patients with known hypersensitivity to levofloxacin, other quinolones, or any component of the formulation.

Side Effects

Common side effects include nausea, vomiting, diarrhea, abdominal pain, and flatulence. Rarely, it may cause retinal detachment or phototoxicity. Very rare side effects include tremors, depression, anxiety, and confusion.

Pregnancy and Lactation

Levofloxacin is not recommended during pregnancy or breastfeeding due to potential unknown effects on the fetus or nursing infant.

Precautions and Warnings

• Administer Evo Injection via slow intravenous infusion only.
• Ensure adequate hydration during treatment to avoid concentrated urine.
• Adjust dosage for patients with renal insufficiency.

Overdose Management

Evo has a low risk of acute toxicity. In case of overdose, empty the stomach and provide supportive care with proper hydration.

Therapeutic Classification

• 4-Quinolone Preparations

Storage Conditions

Store below 30°C, away from light and moisture. Keep out of reach of children.