Mesylate (Figure 1) is a synthetic broad-spectrum antibacterial agent for oral administration.
Fluoroquinolones include levofloxacin (Levaquin), ciprofloxacin (Cipro), moxifloxacin (Avelox), gemifloxacin
(Factive), and delafloxacin (Baxdela), and there are more than 60 generic versions.
The US Food and Drug Administration is requiring labeling changes to clarify the risk of mental health side effects of fluoroquinolones, a class of antibiotics that includes levofloxacin (Levaquin), ciprofloxacin (Cipro), ciprofloxacin extended-release tablets, moxifloxacin (Avelox), ofloxacin, gemifloxacin
(Factive), delafloxacin (Baxdela), and more than 60 generic versions.
The FDA conducted the postmarketing review on all five of the fluoroquinolones (ciprofloxacin, gemifloxacin
, levofloxacin, moxifloxacin, and ofloxacin).
Fewer than 0.5% of patients were treated with a regimen suggesting treatment of a patient with a cephalosporin allergy (e.g., azithromycin plus either gentamicin or gemifloxacin
) or a patient with a complicated gonococcal infection (e.g., azithromycin plus either cefotaxime or ceftizoxime).
Yousef, "Spectrophotometric determination of gemifloxacin
mesylate, moxifloxacin hydrochloride, and enrofloxacin in pharmaceutical formulations using acid dyes," Journal of Analytical Methods in Chemistry, vol.
([section]) Per 10% increase in fluoroquinolone prescribing during the previous year; includes ciprofloxacin, gemifloxacin
, levofloxacin, moxifloxacin, norfloxacin, ofloxacin, and trovafloxacin.
In the case of a severe penicillin allergy, use gemifloxacin
320 mg, single oral dose plus azithromycin 2 g, single oral dose.
pneumoniae Previously healthy Macrolide (preferred) Macrolides: and no risk factors or doxycycline azithromycin, for DRSP clarithromycin, or erythromycin Either respiratory Fluoroquinolones: Comorbidities, fluoroquinolone or moxifloxacin, including the [beta]-lactam plus gemifloxacin
, or following: macrolide (or levofloxacin (i) Recent doxycycline instead Preferred [beta]- use of of macrolide) lactam: high-dose antimicrobials amoxicillin or (ii) Other risks amoxicillin- for DRSP clavulanate Figure 3: Rate of macrolide-resistant S.
Johnson et al., "In vitro activity of gemifloxacin
and contemporary oral antimicrobial agents against 27,247 Gram-positive and Gram-negative aerobic isolates: a global surveillance study," International Journal of Antimicrobial Agents, vol.
(2016) worked in a study to characterize multidrugresistant Shiga toxin-producing Escherichia coli (STEC) harbouring the mcr-1 gene on plasmids cultured from pigs in China and Marino, Blanco, Ginestra, Nostro and Bisignano (2016) characterized the antibacterial activity of gemifloxacin
against methicillin-resistant Staphylococcus aureus (MRSA) ocular isolates in vitro and in a modified ex vivo rabbit keratitis model.