Fluoroquinolones mainly act against gram negative organisms. In patients of young age, they can produce damage to articular cartilage, tendonitis and tendon rupture.

Special Points:

  1. Fluoroquinolones are obtained from synthetic source.
  2. Fluoroquinolones are bactericidal. They bind to two nuclear enzymes involved in DNA replication: 1. DNA gyrase (Topoisomerase II) (mainly in gram negative organisms), 2. Topoisomerase IV (mainly in gram positive organisms)
  3. Levofloxacin, Gemifloxacin, Gatifloxacin, Moxifloxacin are sometimes called RESPIRATORY FLUOROQUINOLONES.

Some important adverse effects of fluoroquinolones:

  1. Fluoroquinolones chelate positive ions like Calcium, magnesium, aluminium, iron, zincso never ingest with food or drugs containing these positive ions – examples – milk, milk products, antacids, hematinics, iron supplements etc.
  2. Fluoroquinolones affect the collagen metabolism and chondrogenesis – hence – Tendonitis, Tendon rupture -Rupture and Erosion of Articular cartilage, and Arthropathy – more effect on weightbearing joints in growing children – also old individuals are susceptible to arthropathy.
  3. Fluoroquinolones do have an adverse effect on CNS – Confusion, hallucinations, insomnia, dizziness, headache, SEIZURES
  4. Gatifloxacin – Hyper/hypoglycemia, 
  5. Trova, Alatrovafloxacin – Hepatotoxicity
  6. Gatifloxacin, Sparfloxacin – QT Prolongation, Arrhythmias
  7. Enzyme inhibition – CP450 enzymes – Inhibition of breakdown of certain drugs and their excess effect and toxicity – example – warfarin – bleeding
  8. Hemolysis in G6PD deficient patients – bleeding
  9. Phototoxicity – Lome, Pe, Spar, Gatifloxacin

A video session shall give you a broad overview.


Mention uses of fluoroquinolones

  1. Urinary tract and genital infections (except moxifloxacin), (Norfloxacin 400 bid oral) Gonorrhea (ciprofloxacin, ofloxacin, single dose treatment), gonococcal cervicitis, Chlamydial urethritis, cervicitis, prostatitis, Chancroid
  2. Upper –lower respiratory infections – Sinusitis, bronchitis, streptococcal infections, CAP, Chlamydia, Mycoplasma, Legionella (levo, gati, gemi, moxi) (respiratory fluoroquinolones
  3. Typhoid fever (ciprofloxacin 750 bid x 10 days)
  4. Postoperative, nosocomial (hospital-acquired)infections
  5. Bacterial diarrhea – Salmonella, Shigella, E coli, Campylobacter
  6. Intraabdominal, pelvic, gynecologic infections
  7. Bones, joints, skin, soft tissue, Eye infections
  8. Anthrax with RMP/ampi/clinda/clarithro
  9. Tuberculosis MDR, XDR, atypical – MAC (Levo – 500 od, Ofloxacin, Cipro, Moxi)
  10. Leprosy (Ofloxacin) (100-200 bid – oral, iv)
  11. Meningeal infections (Peflox 400 bid oral, i.v.) (Ö CNS)
  12. Prophylaxis – meningococcal carrier state, neutropenia
  13. Infections in Patients with Cystic fibrosis, diabetic foot..

Fluoroquinolones – Classification, Examples, Spectrum, Uses


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