___________________________________________________________________________ Antibiotics Review
THE QUINOLONES
Agent
Adult Dosing Range
Pediatric Dosing Range
Route
Common Side Effects
Comments
Besifloxacin
1 drop 3 times daily (4 to 12 hrs apart) for 7 days PO: 250–750 mg every 12 hrs IV: 200–400 mg every 12 hrs PO: 450 mg every 12 hrs for 5 to 14 days IV: 300 mg every 12 hrs for 5 to 14 days Days 1 and 2: 1 drop every 2 hrs while awake Max: 8/day Days 3–7: 1 drop 2 to 4 times/day 250–750 mg/day for 5 to 14 days
Same as adult dosing Ophthal- mic drops
Headache
Contact lenses should not be worn during treatment
Ciprofloxacin
PO: 20–30 mg/kg/ day in 2 divided doses Max: 1.5 g/day IV: 20–30 mg/kg/day
PO, IV, topical, otic, oph- thalmic solution or oint- ment
GI upset, headache
Photosensitivity can occur. Antacids decrease absorption. Can prolong QT interval. Quinolones may cause tendon inflammation and rupture and may exacerbate myasthenia gravis associated muscle weakness.
in 2 divided doses Max: 800 mg/day
Delafloxacin
Not studied in pediatric patients
PO, IV GI upset,
increased serum transaminases
Gatifloxacin
>1 yr: same as adult dosing
Ophthal- mic drops
Headache, GI upset, conjunctival irritation, keratitis
Levofloxacin
N/A
PO, IV, ophthmal- mic drops, inhalation PO, IV, ophthal- mic drops PO, otic, ophthal- mic drops
GI upset, headache, phototoxicity
Moxifloxacin
400 mg/day for 5 to 14 days
N/A
GI upset, headache
Ofloxacin
200–400 mg every 12 hrs
N/A
GI upset, headache
Ozenoxacin
Apply thin layer to affected area (up to 100 cm 2 ) twice/day for 5 days
Infants >2 mos to 12 yrs: Same as adult dosing, except treated area may only be up to 2% of total body surface area (Max: 100 cm 2 ) >12 yrs: same as adult dosing
Topical
<1% experience rosacea-like face eruption,
Novel drug for treatment of impetigo caused by Staphylococcus aureus or Streptococcus pyogenes
seborrheic dermatitis
Prescribing information is given for comparison purposes only. The higher dosage ranges reflect dosages for more severe infections. Please consult the manufacturer’s package insert for the antibiotic for complete prescribing information, maximum dosages, and indications. Source: [6; 16] Table 6
SPECIAL POPULATIONS Quinolones should be used in pregnancy only if clinical benefit exceeds risk and a safer alternative is not available [119]. Because quinolones enter breast milk, their use dur- ing breastfeeding should be avoided if alternative agents are available [119].
Theophylline, phenytoin, and warfarin levels may be elevated in patients concurrently treated with ciprofloxacin. Serum levels or prothrombin time should be monitored, and the doses of these drugs should be altered as appropriate [6]. Dosage adjust- ments are not typically needed with other quinolones [119].
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MDTX2026
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