Fluoroquinolones

What are the fluoroquinolones

Ciprofloxacin (Cipro) IV/PO

Levofloxacin (Levaquin) IV/PO

Moxifloxacin (Avelox) IV/PO

Delafloxacin (Baxdela) IV/PO

Fluoroquinolones MOA

inhibit bacterial topoisomerase

Ciprofloxacin dosing

400mg IV q12h

250-750mg po q12h

Levofloxacin dosing

250-750mg po q24h

Which fluroquinolone does not need to be renally adjusted

Moxifloxacin

Fluoroquinolones: Organisms

Moderate MSSA, strept, enterococcus (cipro poor G+)

most + pseudomonas (not moxi)

moxi has anaerobic

Atypicals

FDA Warning for Fluoroquinolones

CI with myasthenia gravis

Peripheral neuropathy

Neurotoxicity

Tendinitis/Tendon rupture

In what conditions can you use fluoroquinolones if there is no other alternative?

acute chronic bronchitis exacerbation

acute uncomplicated cystitis

acute sinusitis

Fluoroquinolones SE and Pearls

Hypoglycemia

moxi and levo are considered respiratory

photosensitivity

avoid cations

QT prolongation

what is unique about Baxdela?

covers MRSA + pseudomonas

no QT prolongation or photosensitivity