Dexamethasone with levofloxacin

How it works

Dexamethasone reduces inflammation by suppressing inflammatory mediators and vascular permeability, while levofloxacin inhibits bacterial DNA gyrase and topoisomerase IV to provide broad-spectrum bactericidal activity.

Prescribing in practice

• The corticosteroid is contraindicated in undiagnosed red eye and suspected herpes simplex (dendritic) keratitis, where steroids risk corneal perforation, so a viral cause must be excluded before use.
• Prolonged steroid exposure can raise intraocular pressure and promote cataract and secondary infection, so treatment should be short and supervised.
• Avoid contact lens wear during active infection and counsel on correct instillation and storage.

Monitoring

Monitor intraocular pressure with extended use and review corneal status and clinical response, discontinuing if infection or inflammation worsens.

Counselling the patient

• Use exactly as prescribed for the stated course and complete the antibiotic component.
• Report increasing pain, redness or visual disturbance promptly.
• Remove contact lenses while using the drops unless told otherwise.

Evidence & guidelines

Fixed steroid-fluoroquinolone eye drops are an established option for post-surgical and infective-inflammatory ocular conditions, with safety depending on excluding viral keratitis and limiting duration.