Gatifloxacin

Gatifloxacin is a novel extended-spectrum fluoroquinolone with improved Gra m-positive and anaerobe coverage compared with older agents such as ciprofl oxacin. It has good activity (but is slightly less active than ciprofloxaci n) against Enterobacteriaceae. Gatifloxacin is generally 2- to 4-fold more active than ciprofloxacin again st staphylococci, streptococci and enterococci and 4- to 16-fold more activ e than ciprofloxacin against anaerobes, including Clostridium and Bacteroid es spp. In comparative clinical trials that included patients with lower respirator y tract, urinary tract, skin and soft tissue or gonococcal infections, clin ical cure rates of greater than or equal to 89% were achieved with oral gat ifloxacin 400 mg/day for 7 to 14 days. Data from a subset of North American patients included in a multinational t rial showed that oral gatifloxacin 400 mg/day produced a significantly high er clinical cure rate than cefuroxime axetil 250mg twice daily (89 vs 77%; p = 0.01) in patients with acute exacerbations of chronic bronchitis. The c linical efficacy of gatifloxacin was similar to that of clarithromycin or l evofloxacin or ceftriaxone (with or without erythromycin) in the treatment of patients with community-acquired pneumonia. Oral gatifloxacin 400 mg/day showed clinical and bacteriological efficacy s imilar to that of levofloxacin in patients with skin and soft tissue infect ions. In patients with urinary tract infections, clinical cure and bacteria l eradication rates achieved with a single 400mg oral dose of gatifloxacin were similar to those produced with ciprofloxacin. In a pooled analysis of tolerability data from trials that included 3021 pa tients treated with oral gatifloxacin 400 mg/day, the most commonly reporte d adverse events were nausea (8%), diarrhoea (4%), headache (4%) and dizzin ess (3%). The drug was reported to be well tolerated. Gatifloxacin does not appear to cause phototoxic effects.