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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34703
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Good evening, I was prescribed 500 milligrams a day for

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Good evening,

I was prescribed 500 milligrams a day for Levaquin for pyelonephritis for 10 days. However, after the first dose, I experienced a rapid heart rate of 140 beats per minute and felt generally very ill. My doctor then reduced the dosage to 250 milligrams per day. I took 500 milligrams on Tuesday of last week and started with 250 milligrams on Thursday. My question is whether 250 milligrams a day will be strong enough to eradicate the infection. I am also concerned that I may have developed resistance being that I skipped a day in taking the medication. I am a multiple myeloma patient with neutropenia and leukopenia and I often experience more side effects when taking antibiotics. Would cephalexin also be an appropriate antibiotic if Levaquin does not work?


Hello Marissa. Good evening.
I am Dr. Arun and will be helping you today.

Levaquin in the dose of 250 mg per day is occasionally prescribed in the pyelonephritis. This is likely to eradicate the infection in normal individuals, with 10 days course. With neutropenia and leukopenia; there is a small chance that infection would be difficult to eradicate or a longer duration of the antibiotic may be needed. With missing of dose on the second day; is not likely to develop resistance.

Cephalexin is usually not the choice of antibiotic in pyelonephritis.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 4 years ago.


Thank you for taking my question Dr. Phophalia.


May I ask what the usual dosage of Levaquin is in treating pyelonephritis?


If Levaquin does not work, is there another antibiotic of choice? This is my third round of Levquin.

You are very welcome, Marissa.

The usual dose of Levaquin is 500-750 mg. The other antibiotic used in treating pyelonephritis are;

1) ampicillin-sulbactam
2) cefotaxime
3) ceftriaxone
4) ceftazidime
5) ertapenem

It is privilege assisting you.

Dr. Arun
Customer: replied 4 years ago.

One more question if I may, Dr. Phophalia - How many days is the 500 usually milligrams prescribed for?

Levaquin 500 mg usually is prescribed for 5-7 days.
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