I. See Also

II. Precautions

  1. 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

III. Activity Spectrum

  1. Gram Negative Rod coverage (see other Fluoroquinolones)
    1. Enterobacteriaceae
  2. Atypical bacteria
  3. Moderate Gram Positive activity

IV. Indications

  1. Community acquired Pneumonia
  2. Refractory acute bacterial Sinusitis (third line agent)

V. Preparations

  1. Levofloxacin (Levaquin)
  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. Low urine concentrations (avoid in UTI)
  4. Gatifloxacin (Tequin)
    1. Removed from U.S. market in 2006 due to fatalities (Hypoglycemia related)

VI. Adverse Effects

  1. See Fluoroquinolone
  2. Hypoglycemia with Gatifloxacin (Tequin)
    1. Has occurred in non-diabetics
    2. Contraindicated in Diabetes Mellitus

Images: Related links to external sites (from Google)

Cost: Medications

Levofloxacin (on 2/9/2012 at DrugStore.com)
Levofloxacin 250mg Tablets #50 for $30.99 ($0.62/unit)
Levofloxacin 500mg Tablets #50 for $35.99 ($0.72/unit)
Levofloxacin 750mg Tablets #20 for $25.99 ($1.30/unit)
Levaquin (on 2/9/2012 at DrugStore.com)
Levaquin 750mg Tablets #30 for $779.99 ($26.00/unit)
Levaquin 250mg Tablets #10 for $168.00 ($16.80/unit)
Levaquin 500mg Tablets #10 for $185.98 ($18.60/unit)
Avelox (on 2/9/2012 at DrugStore.com)
Avelox 400mg Tablets #30 for $545.98 ($18.20/unit)

Ontology: sparfloxacin (C0052585)

Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH C061363
SnomedCT 387554008, 96090000
English sparfloxacin, sparfloxacin (medication), sparfloxacin [Chemical/Ingredient], Sparfloxacin, Sparfloxacin (product), Sparfloxacin (substance), SPARFLOXACIN
Spanish esparfloxacino, esparfloxacina (producto), esparfloxacino (producto), esparfloxacina, esparfloxacino (sustancia), esparfloxacina (sustancia)

Ontology: Levofloxacin (C0282386)

Definition (NCI) A broad-spectrum, third-generation fluoroquinolone antibiotic and optically active L-isomer of ofloxacin with antibacterial activity. Levofloxacin diffuses through the bacterial cell wall and acts by inhibiting DNA gyrase (bacterial topoisomerase II), an enzyme required for DNA replication, RNA transcription, and repair of bacterial DNA. Inhibition of DNA gyrase activity leads to blockage of bacterial cell growth.
Definition (NCI) A substance used to treat bacterial infections. It belongs to the family of drugs called quinolone antibiotics.
Definition (PDQ) A broad-spectrum, third-generation fluoroquinolone antibiotic and optically active L-isomer of ofloxacin with antibacterial activity. Levofloxacin diffuses through the bacterial cell wall and acts by inhibiting DNA gyrase (bacterial topoisomerase II), an enzyme required for DNA replication, RNA transcription, and repair of bacterial DNA. Inhibition of DNA gyrase activity leads to blockage of bacterial cell growth. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37941&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37941&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1586" NCI Thesaurus)
Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH D015242
SnomedCT 387552007, 96087006
English levofloxacin, levofloxacin (medication), LEVOFLOXACIN, Levofloxacin [Chemical/Ingredient], Ofloxacin, (S)-Isomer, Levofloxacin (product), Levofloxacin (substance), Levofloxacin
Portuguese Levofloxacino
Spanish Levofloxacino, levofloxacino (producto), levofloxacina, levofloxacino, levofloxacino (sustancia), levofloxacina (producto), levofloxacina (sustancia)
German Levofloxacin

Ontology: moxifloxacin (C0536495)

Definition (NCI) A drug used to treat bacterial infections. It is a type of fluoroquinolone.
Definition (NCI) A fluoroquinolone antibiotic with antibacterial activity. Moxifloxacin binds to and inhibits the bacterial enzymes DNA gyrase (topoisomerase II) and topoisomerase IV, resulting in inhibition of DNA replication and repair and cell death in sensitive bacterial species.
Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH C104727
SnomedCT 371296007, 408008008, 412439003
English 1-cyclopropyl--7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinolinecarboxylic acid, moxifloxacin, moxifloxacin [Chemical/Ingredient], Moxifloxacin product (product), Moxifloxacin product, MOXI, Moxifloxacin (product), Moxifloxacin, Moxifloxacin (substance), MOXIFLOXACIN
Spanish Moxifloxacin, Moxifloxacin (product), moxifloxacina, producto (producto), moxifloxacina, producto, moxifloxacina (producto), moxifloxacino (sustancia), moxifloxacino, moxifloxacina, moxifloxacina (sustancia), moxifloxacino (producto)

Ontology: Levaquin (C0721336)

Definition (CHV) brand name levofloxacin
Definition (CHV) brand name levofloxacin
Definition (MSH) Trade name for levofloxacin.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D015242
English levaquin, levaquin [brand name], Levaquin

Ontology: Zagam (C0724448)

Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH C061363
English Zagam, sparfloxacin (Zagam), Aventis Behring brand of sparfloxacin, Bertek brand of sparfloxacin

Ontology: gatifloxacin (C0753645)

Definition (NCI) A synthetic 8-methoxyfluoroquinolone with antibacterial activity against a wide range of gram-negative and gram-positive microorganisms. Gatifloxacin exerts its effect through inhibition of DNA gyrase, an enzyme involved in DNA replication, transcription and repair, and inhibition of topoisomerase IV, an enzyme involved in partitioning of chromosomal DNA during bacterial cell division.
Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH C078049
SnomedCT 371238005, 116349004
English 1-cyclopropyl-1,4-dihydro-6-fluoro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-3-quinolinecarboxylic acid, 3-Quinolinecarboxylic acid, 1-cyclopropyl-6-fluoro-1,4-dihydro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-, 1-cyclopropyl-6-fluoro-8-methoxy-7-(3-methylpiperazin-1-yl)-4-oxo-quinoline-3-carboxylic acid, Gatifloxacin product, gatifloxacin (medication), gatifloxacin, gatifloxacin [Chemical/Ingredient], Gatifloxacin (product), Gatifloxacin (substance), Gatifloxacin, Gatifloxacin product (product), GATIFLOXACIN
Spanish gatifloxacina (producto), gatifloxacina (sustancia), gatifloxacino (sustancia), gatifloxacina, gatifloxacino, gatifloxacino (producto)

Ontology: Avelox (C0875968)

Definition (NCI) A drug used to treat bacterial infections. It is a type of fluoroquinolone.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH C104727
English Avelox, avelox, Avalox, Bayer brand of moxifloxacin hydrochloride, Izilox, Actira

Ontology: Tequin (C0876180)

Concepts Organic Chemical (T109) , Antibiotic(T195)
MSH C078049
English Tequin, tequin