II. Indications

  1. Conditions
    1. Skin and Soft Tissue Infections
    2. Intra-abdominal Infections
  2. Activity Spectrum
    1. Gram Negative Bacteria (Enterobacteriaceae)
    2. Atypical Bacteria
    3. Staphylococcus Aureus (Methicillin susceptible)
    4. Streptococci
      1. Improved coverage over Third Generation Quinolones
    5. Anaerobic Bacteria
      1. Not covered by Third Generation Quinolones
    6. Pseudomonas aeruginosa coverage varies
      1. Delafloxacin (Baxdela) has good Pseudomonas coverage
      2. Trovafloxacin (Trovan) has minimal Pseudomonas coverage

III. Mechanism

IV. Medications: Active

  1. Delafloxacin (Baxdela)
    1. Indicated in acute Skin and Soft Tissue Infections
      1. Limit to resistant infections refractory to other agents
    2. Oral
      1. Delafloxacin 450 mg orally every 12 hours for 5-14 days
    3. 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
    4. 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)

V. Medications: Discontinued

  1. Trovafloxacin (Trovan)
    1. Higher rates of acute liver injury lead to discontinuation in U.S. in 1999
    2. Avoid Trovafloxacin in UTI (low urine concentrations)
  2. Gemifloxacin (Factive)
    1. Uncommon adverse effects including acute liver injury lead to discontinuation in U.S.
    2. Community Acquired Pneumonia: 320 mg orally daily for 5 to 7 days

VI. Adverse Effects

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Related Studies

Ontology: trovafloxacin (C0379881)

Concepts Organic Chemical (T109) , Antibiotic (T195)
MSH C080163
SnomedCT 96092008, 371322001
LNC LP17281-4, MTHU011341
English trovafloxacin, TROVAFLOXACIN, trovafloxacin (medication), trovafloxacin [Chemical/Ingredient], 7-(6-amino-3-azabicyclo[3.1.0]hex-3-yl)- 1-(2,4-difluorophenyl)- 6-fluoro-4-oxo-[1,8] naphthyridine-3-carboxylic acid, Trovafloxacin, Trovafloxacin (substance), Trovafloxacin product (product), Trovafloxacin product
Spanish producto con trovafloxacina (producto), producto con trovafloxacina, trovafloxacina, trovafloxacino (producto), trovafloxacino (sustancia), trovafloxacino, trovafloxacina (producto), trovafloxacina (sustancia)

Ontology: gemifloxacin (C0533545)

Definition (NCI) A fluoroquinolone antibiotic with antimicrobial property. Gemifloxacin enters bacterial cells by diffusion through integral membrane porin pathway before targeting both DNA gyrase and topoisomerase IV, two enzymes critical for DNA replication and repair. This agent binds to the DNA/DNA-gyrase complex and inhibits the A subunits of the enzyme thereby preventing the bacterial chromosome from rejoining. This interferes with DNA replication and repair processes as well as transcription, and ultimately leads to bacterial cell death. Gemifloxacin targets at both Gram-positive, -negative and atypical human pathogens.
Concepts Antibiotic (T195) , Organic Chemical (T109)
MSH C103274
SnomedCT 407086007, 407087003
LNC LP33359-8, MTHU016676
English 7-(3-aminomethyl-4-methoxyimino-pyrrolidine-1-yl)-1-cyclopropyl-6-fluoro-4-oxo-1,4-dihydro-(1,8)-naphthyridine-3-carboxylic acid, Gemifloxacin (substance), Gemafloxacin (substance), Gemifloxacin, Gemafloxacin (product), Gemifloxacin (product), Gemafloxacin, gemifloxacin [Chemical/Ingredient], gemifloxacin, GEMIFLOXACIN
Spanish gemafloxacina (producto), gemafloxacina (sustancia), gemafloxacina, gemifloxacino (producto), gemifloxacino (sustancia), gemifloxacino, gemifloxacina (producto), gemifloxacina, gemifloxacina (sustancia)

Ontology: Trovan (C0723938)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C106856
English Trovan, trovan, Pfizer brand of alatrofloxacin mesylate