Moxifloxacin

 Drug is commonly referred to as “respiratory fluoroquinolone.”

 Moxifloxacin exhibit postantibiotic effect.

Mechanism of action:
 Quinolones block bacterial DNA synthesis by inhibiting bacterial topoisomerase Quinolones
block bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and
topoisomerase IV.
 Inhibition of DNA gyrase (topoisomerase II) prevents the relaxation of positively supercoiled
DNA that is required for normal transcription and replication.
 Inhibition of topoisomerase IV interferes with separation of replicated chromosomal DNA into
the respective daughter cells during cell division.

Antibacterial spectrum:
 Moxifloxacin is usually bactericidal against susceptible organisms.
 Moxifloxacin is slightly less active than ciprofloxacin and ofloxacin against gram-negative
bacteria including gonococci, E coli, Klebsiella pneumoniae, C jejuni, Enterobacter, P aeruginosa,
Salmonella, and Shigella species. but have greater activity against gram-positive Cocci, including
S pneumoniae and some strains of enterococci and Methicillin-resistant Staphylococcus aureus
(MRSA).
 Broadest spectrum Fluoroquinolone with enhanced activity against atypical pneumonia agents
and anaerobes.

Pharmacokinetics:
Route of administration: Oral, IV, drops
Absorption: well absorbed from the GIT with 80-95% bioavailability
Distribution: widely distributed to body fluids and tissues
Metabolism: Metabolized in liver via sulfate conjugation
Half life: Long half life 12-15 hours permitting once daily dosing
Excretion: Non renal , fecal route

Dosing:
Adult dose: 400mg once every 24 hours
Children dose: use and dose must be determined by your doctor

Clinical uses:
 Infections of soft tissues, bones, eyes including bacterial conjunctivitis and joints and in intra-
abdominal infections
  Treatment of TB and atypical mycobacterial infections
 Eradication of meningococcal from carriers or for prophylaxis of infection in neutropenic cancer
patient.
 Treatment of upper and lower RTI (Pseudomonas and Enterobacter)

Brands available in market:

Brands Dosage Strength Route
Avelox Tablet 400mg Oral
Avelox Injection 400mg/250ml IV
Vigamox Solution 0.5%w/v in 25 ml Opthalmic

Adverse effects:
 GIT distress – most common
 QTc prolongation
 Tendonitis
 Atrial fibrillation
 Agranulocytosis

Toxicity:
Symptoms of overdose include CNS and gastrointestinal effects such as decreased activity, somnolence,
tremor, convulsions, vomiting, and diarrhea.

Contraindications:
 Not recommended for children or pregnant women because they may damage growing cartilage
and cause arthropathy.
 Avoided in patients with known QTc prolongation

Drug interactions:
 Fluoroquinolones may increase the plasma levels of theophylline and other methylxanthines,
enhancing their toxicity.
 Avoided with antiarrhythmic or other drugs that increase the QTc interval.

References:
Katzung & Trevor's Pharmacology Examination and Board Review-11th.pdf
Pharmapedia
https://www.mayoclinic.org/drugs-supplements/moxifloxacin-oral-route/proper-use/drg-20072313