Third Generation Fluoroquinolone

Aka: Third Generation Fluoroquinolone, Third Generation Quinolone, Sparfloxacin, Zagam, Gatifloxacin, Tequin

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II. Indications

  1. Conditions
    1. Community Acquired Pneumonia
    2. Refractory acute Bacterial Sinusitis (third line agent)
  2. Activity Spectrum
    1. Gram Negative Rod coverage (see other Fluoroquinolones)
      1. Enterobacteriaceae
    2. Atypical Bacteria
    3. Moderate Gram Positive activity

III. Mechanism

  1. See Fluoroquinolone

IV. Medications

  1. Levofloxacin (Levaquin)
    1. Adult Dose 250 to 750 mg orally or IV daily
    2. QT Prolongation with Levofloxacin (Levaquin)
      1. Three fold increased risk of Sudden Cardiac Death while on Levofloxacin
      2. This appears to be a class effect with most Fluoroquinolones except Ciprofloxacin
      3. Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]
  2. Moxifloxacin (Avelox)
    1. Low urine concentrations (avoid in UTI)
    2. No Pseudomonas coverage
    3. Highest risk Quinolone for QT Prolongation
  3. Sparfloxacin (Zagam)
    1. Associated with higher rates of Photosensitivity Reactions and was withdrawn from U.S. market in 2001
    2. Low urine concentrations (avoid in UTI)
  4. Gatifloxacin (Tequin)
    1. Removed from U.S. market in 2006 due to fatalities (Hypoglycemia related)
    2. Hypoglycemia with Gatifloxacin (Tequin)
      1. Has occurred in non-diabetics
      2. Contraindicated in Diabetes Mellitus

V. Adverse Effects

  1. See Fluoroquinolone

VI. References

  1. King (2000) Am Fam Physician 61(9):2741-8 [PubMed]
  2. O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513 [PubMed]
  3. Oliphant (2002) Am Fam Physician 65(3):455-64 [PubMed]
  4. Owens (2000) Med Clin North Am 84(6):1447-69 [PubMed]

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Related Studies

Cost: Medications

gatifloxacin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
GATIFLOXACIN 0.5% EYE DROPS Generic $10.81 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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