gatifloxacin (Tequin, Zymar)
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Introduction
Tradenames: Tequin, Zymar. Bristol-Myers Squibb is no longer selling Tequin (2006)
Indications
- bacterial infections due to susceptible organisms
- community-acquired pneumonia
- sinusitis
- acute exacerbation of chronic bronchitis
- pulmonary tuberculosis[8]
- ophthalmic for prevention & treatment of eye infections
Contraindications
- do NOT use in patients with diabetes mellitus[7]
- caution in the elderly, renal insufficieny
Dosage
Tablets
Injection (IV)
Ophthalmic: (Zymar)[4]
Dosage adjustment in renal failure
Table
| creatinine clearance | dosage |
|---|---|
| > 50-90 mL/min | 400 mg QD |
| 10-50 mL/min* | 200 mg QD |
| < 10 mL/min# | 200 mg QD |
* same dose for continuous arteriovenous hemofiltration
# 200 mg after hemodialysis
Pharmacokinetics
Antimicrobial activity
- Gram-positive (activity enhanced)
- Gram negative
- atypical
Adverse effects
- may prolong QT interval, but clinically not significant (so far)
- hypoglycemia (generally within 1st 3 days)[7]
- hyperglycemia (generally after 3 days)[7]
Drug interactions
- may cause severe hypoglycemia when used in combination with sulfonylureas, repaglinide (Prandin) & other hypoglycemic agents.
- drug interaction(s) anticonvulsants with anti-bacterial agents
- drug interaction(s) of antibiotics with warfarin
- drug interaction(s) of theophylline with fluoroquinolone
- drug interaction(s) of beta-adrenergic receptor antagonists with quinolones
- drug interaction(s) of fluroquinolones with amiodarone
- drug interaction(s) of fluroquinolones with sulfonylureas
- drug interaction(s) of fluoroquinolones with hypoglycemic agents
More general terms
More specific terms
References
- ↑ Prescriber's Letter 7(2):7, Feb. 2000
- ↑ Sanford Guide to antimicrobial therapy 2001
- ↑ Prescriber's Letter 9(11):64 2002
- ↑ 4.0 4.1 4.2 Prescriber's Letter 10(5):27 2003
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ Prescriber's Letter 13(1): 2006 Glucose abnormalities and fluoroquinolones Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220109&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 7.0 7.1 7.2 7.3 FDA MedWatch http://www.fda.gov/medwatch/safety/2006/safety06.htm#Tequin
Prescriber's Letter 13(3): 2006 Glucose Abnormalities and Fluoroquinolones - An Update Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220315&pb=PRL (subscription needed) http://www.prescribersletter.com
Park-Wyllie LY et al, Outpatient gatifloxacin therapy and dysglycemia in older adults. N Engl J Med 2006 Mar 30; 354. http://dx.doi.org/10.1056/NEJMoa055191
Gurwitz JH. Serious adverse drug effects - Seeing the trees through the forest. N Engl J Med 2006 Mar 30; 354. http://dx.doi.org/10.1056/NEJMe068051 - ↑ 8.0 8.1 8.2 8.3 Deprecated Reference