II. Indications

  1. Second-Line Agent for refractory covered infections
  2. Acute Skin Infections
  3. Acute skin structure infections

III. Contraindications

  1. Fluoroquinolone Hypersensitivity

IV. Pharmacology: Mechanism

  1. Inhibition of Bacterial enzymes (DNA replication, transcription, repair, recombination)
    1. Bacterial Topoisomerase 4
    2. DNA gyrase (Topoisomerase 2)

V. Pharmacology: Activity Spectrum

  1. Broad Gram Positive Bacteria coverage (including otherwise Quinolone resistant organisms)
    1. Methicillin Resistant Staphylococcus Aureus (MRSA, as well as MSSA)
    2. Staphylococcus Haemolyticus
    3. Staphylococcus lugdunensis
    4. Streptococcus Pyogenes
    5. Streptococcus agalactiae
    6. Streptococcus anginosus (as well as Streptococcus intermedius and Streptococcus constellatus)
    7. Enterococcus faecalis
  2. Gram Negative Bacteria
    1. Escherichia coli
    2. Enterobacter cloacae
    3. Klebsiella Pneumoniae
    4. Pseudomonas aeruginosa

VI. Dosing

  1. Oral
    1. Delafloxacin 450 mg orally every 12 hours for 5-14 days
  2. Parenteral
    1. Delafloxacin 300 mg IV over 60 minutes every 12 hours
    2. Decrease dose to 200 mg IV every 12 hours if GFR 15-30 ml/min
    3. Transition to oral dosing when able
  3. Renal
    1. Adjust IV dose for GFR 15-30 ml/min (see above)
    2. Avoid Delafloxacin for GFR <15 ml/min (End Stage Renal Disease)

VII. Adverse Effects

  1. Common
    1. Nausea or Vomiting (8%)
    2. Diarrhea (8%)
    3. Headache (3%)
  2. Serious
    1. See Fluoroquinolone

IX. References

  1. LoVecchio (2021) Crit Dec Emerg Med 35(3): 24
  2. Smith and LoVecchio (2017) Crit Dec Emerg Med 31(11):24

Images: Related links to external sites (from Bing)

Related Studies