Category:

• Antibiotic

Description:

• Fluoroquinolone antibiotic

Indications:

• Lower respiratory tract infections (E. coli, Klebsiella pneumonia, Enterobacter cloacae, P. mirabilis, P. aeruginosa, H. influenzae, H. parainfluenzae, S. pneumoniae)

• Skin infections (E. coli, K. pneumoniae, E. cloacae, P. mirabilis, P. vulgaris, Providencia stuartii, M. morganii, Citrobacter freundii, S. pyogenes, P. aeruginosa, S. aureus, S. epidermidis)

• Bone/joint infections (E. cloacae, Serratia marcescens, P. aeruginosa)

• Urinary tract infections (E. coli, K. pneumoniae, E. cloacae, S. marcescens, P. mirabilis, Providencia rettgeri, M. morganii, Citrobacter diversus, C. freundii, P. aeruginosa, S. eipdermidis, Entercoccus faecalis)

• Infectious diarrhea (E. coli, Campylobacter jejuni, Shigells flexneri, Shigella sonnei)

• Typhoid fever (Salmonella typhi)

• Sexually transmitted diseases (N. gonorrhoeae)

• Anthrax treatment and exposure prophylaxis

• Unlabeled uses:

• cystic fibrosis

• malignant external otitis

• tuberculosis

• Mycobaterium avium complex infection in AIDS patients

Contraindications:

• None

Precautions:

• Pregnancy category C

• May cause photosensitivity reactions

• May cause pseudomembranous colitis

• Do not use in young children due to possible cartilage abnormalities

• May cause ophthalmologic abnormalities

• Administer on an empty stomach

• Do not take with antacids, iron, aluminum, magnesium or zinc preparations, milk or dairy products

• May cause dizziness or lightheadedness, use caution when performing tasks

• Take each dose with a full glass of water

• Take on empty stomach, food delays absorption.  Optimal dosing is 2 hours after eating

• Complete full course of therapy

Adverse Reactions (Side Effects):

• Angina pectoris, bronchospasm, dyspnea

• Bad taste in mouth

• Mental confusion, restlessness

Dosage:

• Administered orally (capsules and suspension) and by IV injection

• UTIs (mild/moderate): 

  • 250mg po q12h or 200mg IV q12h

• UTIs (serious/complicated): 

  • 500mg po q12h or 400mg IV q12h

• Lower resp, skin, bone or joint infection (mild/moderate): 

  • 500mg po q12h or 400mg IV q12h

• Lower resp, skin, bone or joint infection (serious/complicate): 

  • 750mg po q12h or 400mg IV q8h

• Infectious diarrhea: 

  • 500mg po q12h

• Typhoid fever: 

  • 500mg po q12h

• Urethral/Cervical gonococcal infections (uncomplicated): 

  • 250-500mg single dose

• Chancroid: 

  • 500mg q12h for 3 days

• Disseminated gonococcal infections: 

  • 500mg q12h for 7 days following initial treatment with ceftriaxone (1 gram IM or IV q24h until 24-48 after improvement)

• Anthrax:

  • 1200-2400mg/day with pyrimethamine

  • treatment: 

    • Adult: 400mg IV q12h

    • Child: 2-30mg/kg/day in 2 divided doses

  • prophylaxis: 

    • Adult: 500mg po bid

    • Child: 20-30mg/kg/day divided q12h

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001