Methicillin-Sensitive Staphylococcus Aureus (MSSA): not recommended (as only levofloxacin/moxifloxacin/gemifloxacin are active)
Methicillin-Resistant Staphylococcus Aureus (MRSA): not recommended (as there are high levels of resistance to ciprofloxacin and newer fluoroquinolones)
Methicillin-Sensitive Staphylococcus Epidermidis (MSSE): not recommended (as only levofloxacin/moxifloxacin/gemifloxacin are active)
Methicillin-Resistant Staphylococcus Epidermidis (MRSE): not recommended (as there are high levels of resistance to ciprofloxacin and newer fluoroquinolones)
Streptoccocus Pneumoniae (see Streptoccocus Pneumoniae, [[Streptoccocus Pneumoniae]]): newer fluoroquinolones have increased activity against Streptococcus Pneumoniae and other Gram-positive organisms, as compared to ciprofloxacin
Anerobes
Bacteroides (see Bacteroides, [[Bacteroides]]): not recommended (as moxifloxacin is the only current fluoroquinolone with clinically-significant anaerobic coverage)
Respiratory Pathogens
Chlamydophila Pneumoniae (see Chlamydophila Pneumoniae, [[Chlamydophila Pneumoniae]]): not recommended
Haemophilus Influezae (see Haemophilus Influezae, [[Haemophilus Influezae]]): not recommended
Legionella Pneumophila (see Legionellosis, [[Legionellosis]]): not recommended
Moraxella Catarrhalis (see Moraxella Catarrhalis, [[Moraxella Catarrhalis]]): not recommended
Mycoplasma Pneumoniae (see Mycoplasma Pneumoniae, [[Mycoplasma Pneumoniae]]): not recommended
Streptoccocus Pneumoniae (see Streptoccocus Pneumoniae, [[Streptoccocus Pneumoniae]]): newer fluoroquinolones have increased activity against Streptococcus Pneumoniae and other Gram-positive organisms, as compared to ciprofloxacin
Pharmacology
Fluoroquinolone Antibiotic (see Fluoroquinolones, [[Fluoroquinolones]])
Metabolism
xxx
Administration
PO:
IV:
Dose Adustment
Hepatic:
Renal
Adverse Effects
Cardiovascular Adverse Effects
Q-T Prolongation with Definite Association with Torsade (see Torsade, [[Torsade]])
Epidemiology: fluoroquinolones have a definite association with torsade
However, the risk of Q-T prolongation with fluoroquinolones is mainly related to additive effects with other Q-T prolonging drugs, as the risk when used alone is small
Levofloxacin (Levaquin) (see Levofloxacin, [[Levofloxacin]])
Ofloxacin (Floxin, Ocuflox) (see Ofloxacin, [[Ofloxacin]])
Sitafloxacin (Gracevit) (see Sitafloxacin, [[Sitafloxacin]])
Tosufloxacin (Ozex) (see Tosufloxacin, [[Tosufloxacin]])
Low Risk
Ciprofloxacin (Cipro)
Canadian Drug Safety and Effectiveness Research Network (CDSERN) Study of Sudden Death in Patients Co-Prescribed Sulfamethoxazole/Trimethoprim + Either ACE-I or ARB’s(2014) [MEDLINE]
Study: n = 39,879 sudden deaths -> 1027 occurred within 7 days of exposure to an antibiotic
Main Findings: ciprofloxacin was also associated with an increased risk of sudden death (adjusted odds ratio 1.29, 1.03 to 1.62)
Hematologic Adverse Effects
Acquired Von Willebrand Disease (see Von Willebrand Disease, [[Von Willebrand Disease]]):