II. Indications
- Conditions
- Skin and Soft Tissue Infections
- Intra-abdominal Infections
- Activity Spectrum
- Gram Negative Bacteria (Enterobacteriaceae)
- Atypical Bacteria
- Staphylococcus aureus (Methicillin susceptible)
- Streptococci
- Improved coverage over Third Generation Quinolones
- Anaerobic Bacteria
- Not covered by Third Generation Quinolones
- Pseudomonas aeruginosa coverage varies
- Delafloxacin (Baxdela) has good Pseudomonas coverage
- Trovafloxacin (Trovan) has minimal Pseudomonas coverage
III. Mechanism
- See Fluoroquinolone
IV. Medications: Active
-
Delafloxacin (Baxdela)
- Indicated in acute Skin and Soft Tissue Infections
- Limit to resistant infections refractory to other agents
- Oral
- Delafloxacin 450 mg orally every 12 hours for 5-14 days
- Parenteral
- Delafloxacin 300 mg IV over 60 minutes every 12 hours
- Decrease dose to 200 mg IV every 12 hours if GFR 15-30 ml/min
- Transition to oral dosing when able
- Renal
- Adjust IV dose for GFR 15-30 ml/min (see above)
- Avoid Delafloxacin for GFR <15 ml/min (End Stage Renal Disease)
- Indicated in acute Skin and Soft Tissue Infections
V. Medications: Discontinued
- Trovafloxacin (Trovan)
- Higher rates of acute liver injury lead to discontinuation in U.S. in 1999
- Avoid Trovafloxacin in UTI (low urine concentrations)
- Gemifloxacin (Factive)
- Uncommon adverse effects including acute liver injury lead to discontinuation in U.S.
- Community Acquired Pneumonia: 320 mg orally daily for 5 to 7 days
VI. Adverse Effects
- See Fluoroquinolone