Fluoroquinolones

Kinetics	Dosage
Spectrum	Indications
Side Effects	Drug Interactions

 

Drug	Available as	Usual Dosage	F	Elimination	t½
Ciprofloxacin (Cipro®)	IV 400 mg PO 250, 500, 750 mg	400 mg IV q12h 500 mg PO q12h	0.7	Renal: 66% Hepatic: 33%	6 hrs
Gatifloxacin (Tequin®)	IV 400 mg PO 400 mg	400 mg q24h	0.95	Renal: 80%	8 hrs
Levofloxacin (Levaquin®)	IV 25 mg/ml (20 ml) PO 250, 500 mg	500 mg q24h	1	Renal: 85%	7 hrs
Moxifloxacin (Avelox®)	PO 400 mg	400 mg PO q24h	0.95	Renal: 20%	12 hrs
Norfloxacin (Norflox®)	PO 400 mg	400 mg PO q12h	0.35	Renal: 30%	4 hrs
Ofloxacin (Floxin®)	IV 200, 400 mg PO 200, 400 mg	400 mg q12h	0.98	Renal: 70%	6 hrs

Drug	Spectrum of activity	Indications
Ciprofloxacin (Cipro®)	Aerobic GNB (+ Pseud.) Aerobic GPC (Staph; E. faecalis; Strep. pyogenes)	Acute sinusitis, lower respiratory tract infection, UTI, acute uncomplicated cystitis, chronic bacterial prostatitis, complicated intra-abdominal infection, skin and skin structure infection, bone and joint infection, infectious diarrhea, Typhoid Fever, uncomplicated cervical and urethral gonorrhea
Gatifloxacin (Tequin®)	Aerobic GNB (not pseudomonas) Aerobic GPC (Staph, PRSP*) Atypicals (Legionella, Mycoplasma, Chlamydia Pneum.)	Acute sinusitis, acute bacterial exacerbation of chronic bronchitis, community acquired pneumonia, uncomplicated and complicated UTI, pyelonephritis, uncomplicated urethral and cervical gonorrhea, acute uncomplicated rectal infection
Levofloxacin (Levaquin®)	Aerobic GNB (+ pseud) Aerobic GPC (Staph; Strep. Pneumo and pyogenes; E. faecalis) Atypicals (Legionella, Mycoplasma, Chlamydia Pneumo)	Acute maxillary sinusitis, acute bacterial exacerbation of chronic bronchitis, community acquired pneumonia, uncomplicated skin and skin structure infection, complicated and uncomplicated UTI, acute pyelonephritis
Moxifloxacin (Avelox®)	Aerobic GNB (not pseudomonas) Aerobic GPC (Staph, PRSP*) Atypicals (Legionella, mycoplasma, Chlamydia Pneumo) Anaerobes (Bacteroides)	Acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, community acquired pneumonia
Norfloxacin (Norflox®)	Aerobic GNB (+ pseud) Aerobic GPC (Staph, E. faecalis)	Uncomplicated UTI and cystitis, uncomplicated urethral and cervical gonorrhea, prostatitis
Ofloxacin (Floxin®	Aerobic GNB (not pseud) Aerobic GPC (Staph, Strep pneumo and pyogenes, E. faecalis)	Lower respiratory tract infection, spontaneous bacterial peritonitis (SBP), skin and skin structure infection, uncomplicated UTI
*PRSP = penicillin-resistant streptococcus pneumoniae

Drug	Adverse Effects	Drug Interactions
Ciprofloxacin (Cipro®)	Headache, restlessness, N/V, diarrhea, rash, ñAST/ALT, ñScr	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption. Cipro Þ ñ levels of caffeine, theophylline Cipro Þ ñ CSA level Cimetidine, probenecid Þ ñ FQN level
Gatifloxacin (Tequin®)	N/V, diarrhea, dizziness, taste perversion, insomnia, constipation; Q-T prolongation	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption. Cimetidine, probenecid Þ ñ FQN level Gatiflox may Þ ñ levels of warf and dig
Levofloxacin (Levaquin®)	Headache, N/V, diarrhea, dizziness, anxiety, constipation, anorexia, insomnia, rash, ñAST/ALT, leukopenia, thrombocytopenia, tremor, arthralgia	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption Antineoplastics Þ ¯levoflox level Cimetidine, probenecid Þ; ñ FQN level Levo Þ ñ levels of digoxin, caffeine, warfarin, cyclosporine Levo Þ ¯ levels of phenytoin
Moxifloxacin (Avelox®)	N/V, diarrhea, headache, abd pain, elevated LFTs, dyspepsia, Q-T prolongation	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption. Additive effects with drugs that prolong Q-T interval; quinidine, procainamide, amiodarone, sotalol should be avoided
Norfloxacin (Norflox)	N/V, headache, dizziness, elevated LFTs, leukopenia, neutropenia	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption. Norflox Þ ñ levels of theophylline, caffeine, warfarin, cyclosporine Nitrofurantoin: anti-bacterial effect antagonized Norflox Þ ¯ levels of phenytoin Antineoplastics Þ ¯ levels of norflox Cimetidine, probenecid Þ ñ FQN level
Ofloxacin (Floxin®)	N/V, diarrhea, abd pain, headache, dizziness, dry mouth, drowsiness, insomnia, rash, visual disturbance, eosinophilia, lymphocytopenia, hematuria, glucosuria, leukocytosis	Al, Mg, Ca, Fe, Zn Þ ¯ FQN absorption. Cimetidine, probenecid Þ ñ FQN level Oflox Þ ñ levels of theophylline, caffeine, warfarin, cyclosporine