ofloxacin (Floxin, Ocuflox, Floxin Otic)
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Introduction
Tradenames: Floxin, Ocuflox (ophthalmic)
Indications
- bacterial infections due to susceptible organisms
- Otic solution: (Floxin Otic)
- treatment of otitis externa
- otitis media in pediatric patients with tympanostomy tubes
- chronic suppurative otitis media in patients > 12 years of age with perforated tympanic membranes
- Ophthalmic agent
- susceptible eye infections
Contraindications
- ophthalmic agent
- epithelial herpes simplex keratitis
- vaccinia
- varicella
- mycobacterial infections of the eye
- fungal eye infections
- use of steroids after uncomplicated removal of corneal foreign body
Caution:
- seizure disorder
Dosage
- systemic agent
- Ophthalmic agent: 1 drop every 1-6 hours
Tabs: 200, 300, 400 mg
Solution: (ophthalmic) 0.35% (5 mL)
Dosage adjustment in renal failure
- initial dose is the same, regardless of renal failure
- creatinine clearance 10-50 mL/min: QD dosing
- creatinine clearance < 10 mL: 50% of dose with QD dosing
- 100-200 mg IV after hemodialysis
Pharmacokinetics
- well absorbed after oral administration
- unaffected by food
- aral route achieves similar concentration to parenteral route
- widely distributed to body tissues & fluids
- crosses placenta
- distributed to breast milk
- protein binding 20-32%
- elimination 1/2life: 4-8 hours (28-37 hours ESRD)
- excreted primarily unchanged in the urine
elimination via liver
elimination via kidney
1/2life = 5-8 hours
protein binding = 25 %
elimination by hemodialysis = +
Antimicrobial activity
- Streptococcus (+/-)
- Streptococcus group A (+/-)
- Streptococcus group B (+/-)
- Streptococcus group C (+/-)
- Streptococcus group G (+/-)
- Streptococcus pneumonia (+/-)*
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Neisseria gonorrhoeae
- Neisseria meningitidis
- Moraxella catarrhalis
- Haemophilus influenzae
- Escherichia coli
- Klebsiella species
- Enterobacter species
- Serratia species
- Salmonella species
- Shigella species
- Proteus mirabilis
- Proteus vulgaris
- Providencia species
- Morganella species
- Citrobacter species
- Aeromonas species
- Acinetobacter species (+/-)
- Pseudomonas aeruginosa (+/-)
- Yersinia enterocolitica
- Legionella species
- Pasteurella multocida
- Actinomyces (+/-)
- Clostridium species (+/-)
- Peptostreptococcus species (+/-) *Among the quinolones, ofloxacin has the best activity against Chlamydia & pneumococci.
Ofloxacin & ciprofloxacin are used in multidrug regimens for treatment of drug-resistant Mycobacterium tuberculosis.
Adverse effects
Drug interactions
- sucralfate, aluminum & magnesium containing antacids, products containing zinc, calcium or iron may decrease bioavailability of ofloxacin
- probenecid may decrease renal clearance of ofloxacin
- ofloxacin may increase anticoagulant effect of warfarin
- 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
Laboratory
- ofloxacin in serum/plasma
- methods: HPLC, MB
- interferences:
- other anti-microbials may interfere with microbiologic (MB) assay
More general terms
More specific terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 165
- ↑ Sanford Guide to antimicrobial therapy 1997
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
- ↑ 6.0 6.1 6.2 Deprecated Reference
- ↑ Department of Veterans Affairs, VA National Formulary