II. Indications
- Second-Line Agent for refractory covered infections
- Acute Skin Infections
- Acute skin structure infections
III. Contraindications
- Fluoroquinolone Hypersensitivity
IV. Pharmacology: Mechanism
- Inhibition of Bacterial enzymes (DNA Replication, transcription, repair, recombination)
- Bacterial Topoisomerase 4
- DNA gyrase (Topoisomerase 2)
V. Pharmacology: Activity Spectrum
- Broad Gram Positive Bacteria coverage (including otherwise Quinolone resistant organisms)
- Methicillin Resistant Staphylococcus Aureus (MRSA, as well as MSSA)
- Staphylococcus Haemolyticus
- Staphylococcus lugdunensis
- Streptococcus Pyogenes
- Streptococcus agalactiae
- Streptococcus anginosus (as well as Streptococcus intermedius and StreptococcusConstellatus)
- Enterococcus faecalis
-
Gram Negative Bacteria
- Escherichia coli
- Enterobacter cloacae
- Klebsiella Pneumoniae
- Pseudomonas aeruginosa
VI. Dosing
- 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)
VII. Adverse Effects
- Common
- Serious
- See Fluoroquinolone
VIII. Resources
IX. References
- LoVecchio (2021) Crit Dec Emerg Med 35(3): 24
- Smith and LoVecchio (2017) Crit Dec Emerg Med 31(11):24