Ciprofloxacin (Cipro) (see Ciprofloxacin, [[Ciprofloxacin]])
Gatifloxacin (Tequin) (see Gatifloxacin, [[Gatifloxacin]])
Gemifloxacin (Factive) (see Gemifloxacin, [[Gemifloxacin]])
Grepafloxacin (Raxar) (see Grepafloxacin, [[Grepafloxacin]]): withdrawn from worldwide markets in 1999
Levofloxacin (Levaquin) (see Levofloxacin, [[Levofloxacin]])
Moxifloxacin (Avelox, Avalox, Avelon) (see Moxifloxacin, [[Moxifloxacin]])
Ofloxacin (Floxin, Ocuflox) (see Ofloxacin, [[Ofloxacin]])
Sitafloxacin (Gracevit) (see Sitafloxacin, [[Sitafloxacin]])
Sparfloxacin (Spacin, Zagam) (see Sparfloxacin, [[Sparfloxacin]]): withdrawn from US market
Tosufloxacin (Ozex) (see Tosufloxacin, [[Tosufloxacin]])
Trovafloxacin (Trovan, Turvel) (see Trovafloxacin, [[Trovafloxacin]]): withdrawn from US market
Pharmacology
Fluoroquinolone Antibiotics
Gram-Negative Coverage
Fluoroquinolones Have Adequate Activity Against Enteric Gram-Negative Rods
General Spectrum of Gram-Negative Rod Activity: levofloxacin had same overall spectrum of activity again Gram-negative rods as ofloxacin, but is 2x more potent
Pseudomonas Aeruginosa: levofloxacin has less activity against than ciprofloxacin
Pseudomonas Aeruginosa/Serratia/Providencia/Proteus: moxifloxacin has less activity against these organisms than ciprofloxacin
Gram-Positive Coverage
Newer Fluoroquinolones Have Increased Activity Against Streptococcus Pneumoniae and Other Gram-Positive Organisms, as Compared to Ciprofloxacin
Methicillin-Sensitive Staphylococcus Aureus (MSSA): levofloxacin/moxifloxacin/gemifloxacin are active
Methicillin-Sensitive Staphylococcus Epidermidis (MSSE): levofloxacin/moxifloxacin/gemifloxacin are active
Methicillin-Resistant Staphylococcus Aureus (MRSA): have high levels of resistance to ciprofloxacin and newer fluoroquinolones
Methicillin-Resistant Staphylococcus Epidermidis (MRSE): have high levels of resistance to ciprofloxacin and newer fluoroquinolones
Enterococcus: levofloxacin/moxifloxacin activities are marginal
Anerobic Coverage
Moxifloxacin is the Only Currently Available Agent Which Has Clinically-Significant Anaerobic Coverage
Bacteroides Species: anaerobic activity of moxifloxacin has been shown to be comparable to that of piperacillin-tazobactam (Zosyn) and amoxicillin-clavulanic acid (Augmentin)
However, resistance rates may be as high as 25-30% in some centers
Respiratory Pathogen Coverage
Streptococcus Pneumoniae: newer fluoroquinolones have increased activity against Streptococcus Pneumoniae and other Gram-positive organisms, as compared to ciprofloxacin
Gemifloxacin Has Unusually High Activity Against Streptococcus Pneumoniae, as Compared to Other Fluoroquinolones
Haemophilus Influezae/Moraxella Catarrhalis/Legionella Pneumophila/Mycoplasma Pneumoniae/Chlamydophila Pneumoniae: all newer fluoroquinolones have good activity against these pathogens
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
