Second Generation Fluoroquinolone

Aka: Second Generation Fluoroquinolone, Second Generation Quinolone, Ciprofloxacin, Ofloxacin, Norfloxacin

1. See Also
   1. Fluoroquinolone
2. Activity Spectrum (See Class I and Class II below)
   1. Gram Negative Rod coverage (see other Fluoroquinolones)
   2. Some atypical bacteria coverage (Class II only)
   3. See Ciprofloxacin below for other activity
3. Preparations: Class I
   1. Indications
      1. Uncomplicated Urinary Tract Infections
   2. Similar spectrum to first generation agents
      1. Improved Gram Negative coverage over first generation
      2. Low systemic drug concentrations
   3. Agents
      1. Lomefloxacin (Maxaquin)
      2. Enoxacin (Penetrex)
      3. Norfloxacin (Noroxin)
4. Preparations: Class II
   1. Indications
      1. Complicated Urinary Tract Infections
      2. Specific types of bacterial Gastroenteritis
      3. Prostatitis
      4. Sexually Transmitted Disease
      5. Avoid in community acquired Pneumonia
         1. Risk of pneumococcal bacteremia and Meningitis
   2. Additional Indications for Ciprofloxacin
      1. Pseudomonas aeruginosa
      2. Bacillus anthracis or Anthrax (first line agent)
      3. Vibrio Cholerae (Norfloxacin also covers)
      4. Yersinia pestis or Plague (first line agent)
      5. Tularemia (alternative medication)
   3. Significantly more active than Class I agents
      1. Broader Gram Negative coverage than Class I agents
      2. High systemic drug concentrations
      3. Some atypical bacteria coverage
      4. Pseudomonas aeruginosa (Ciprofloxacin only)
   4. Agents
      1. Ciprofloxacin (Cipro)
      2. Ofloxacin (Floxin)
5. Directions
   1. Take on an empty Stomach
   2. Take more than 1 hour before or two hours after food
6. References
   1. King (2000) Am Fam Physician 61(9):2741-8
   2. O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513
   3. Oliphant (2002) Am Fam Physician 65(3):455-64
   4. Owens (2000) Med Clin North Am 84(6):1447-69