Fluoroquinolones= Quinolones
Ciprofloxacin (Cipro-PO & IV) Moxifloxacin (Avelox –PO & IV) Levofloxacin (Levaquin– PO & IV), Norfloxacin– PO
- Inhibits bacterial DNA synthesis
- Covers: Broad spectrum activity for Gram+ & Gram- organisms, Aerobic Gram- Bacilli (Enterobacter, Haemophilus), Gram- Cocci (Neisseria, M.Catarrhalis), & active against Staphylococcus & Mycoplasma
- Fluroquinolones should be reserved for moderate infections & bacterial infections that are resistant to other antibiotics
- Fluoroquinolones have excellent absorption after oral administration
- Ciprofloxacin & Levofloxacin are the only Quinolones active against Pseudomonas aeruginosa
- Used for: UTI’s that are difficult to treat with other drugs, respiratory infections, bacterial diarrheas, Anthrax, Chlamydia, Community-acquired pneumonia, Complicated Sinusitis, skin infections, bone infections, genital infections and more
- CDC does not recommend the use of Fluoroquinolones to treat Gonorrhea
- Moxifloxacin (Avelox) cannot be used to treat UTI’s because it is not excreted in the urine (Do not use for UTI’s)
- Monitor renal, hepatic & hematopoietic functions during prolonged therapy
- Monitor INR/PT & Theophylline levels
- Patients on Coumadin or Theophylline should be monitored closely because it can increase the serum levels of these drugs
- Should be taken at least 2 hours before of 6 hours after products that contain Al, Mg, Fe, ZN & Sulcralfate
- Side effects: GI irritation, CNS symptoms (headache, confusion, seizures, sleep disorders), Photosensitivity, Prolong QT interval, Tendon Rupture, Tendinitis, damage to cartilage in children & pregnant women (can be used to treat children with Cystic Fibrosis with Pseudomonas aeruginosa), Crystalluria, hyper or hypoglycemia.
- Warnings have be issued for increased risk of tendon rupture of shoulder, hands, Achilles & other tendons in patients older than 65
- Patients should be instructed to discontinue therapy if they experience symptoms & avoid exercise until tendonitis/tendon rupture has been ruled out
- Use during pregnancy only if benefits outweigh the risks to fetus