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Rifampicin + levofloxacin is a combination of two antibiotics used primarily for the treatment of certain severe bacterial infections, including prosthetic joint infections and tuberculous meningitis. Rifampicin is a rifamycin antibiotic that inhibits DNA-dependent RNA polymerase in susceptible organisms, thereby suppressing RNA synthesis and leading to cell death. Levofloxacin is a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for DNA replication, transcription, repair, and recombination. The combination leverages the bactericidal activity of both drugs; however, some studies have shown potential antagonism between them in certain settings. This regimen is often considered when resistance or intolerance to standard therapies exists or when enhanced tissue penetration (such as bone or central nervous system) is required[1][2][3][6][7].
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