Mehlman Cardiology Practice Exam

Levofloxacin is commonly used for pneumonia, including hospital-acquired pneumonia, because it combines broad spectrum activity with excellent lung penetration and convenient pharmacokinetics. It effectively covers the usual pneumonia pathogens—Streptococcus pneumoniae, Haemophilus influenzae, and atypicals such as Mycoplasma and Legionella—and can provide activity against Pseudomonas in some settings, making it a versatile option for both community and hospital cases. Its high lung tissue concentrations and good oral bioavailability allow it to be used as monotherapy in appropriate cases or as step-down therapy from IV to oral. In contrast, ciprofloxacin, while strong against Gram-negatives like Pseudomonas, has weaker coverage of S. pneumoniae; moxifloxacin has strong Gram-positive and anaerobic activity but limited Pseudomonas coverage, and ofloxacin has less favorable pharmacokinetics and spectrum. Thus levofloxacin best fits the needs for pneumonia management among the fluoroquinolones.