Moxifloxacin: Clinical efficacy and safety

The activity, pharmacokinetics, pharmacodynamics, efficacy, safety, drug in teractions, and dosage acid administration of moxifloxacin are reviewed, Moxifloxacin is an oral 8-methoxyquinolone antimicrobial approved in Decemb er 1999 for use in the treatment of acute bacterial sinusitis, acute bacter ial exacerbations of chronic bronchitis, and community-acquired pneumonia. This fluoroquinolone is active against common community-acquired respirator y pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Moraxella ca tarrhalis), atypical pathogens, and many anaerobes. Moxifloxacin has an abs olute bioavailability of 90% after oral administration and a mean eliminati on half-life of 12 hours. The drug is not a substrate or inhibitor of the h epatic cytochrome P-450 isoenzyme system, thereby avoiding many potential d rug interactions. Moxifloxacin has limited phototoxic potential. In clinica l trials, moxifloxacin had clinical success rates of 88-97% and bacteriolog ic eradication rates of 90-97%. Reported adverse effects were primarily gas trointestinal (nausea, diarrhea) and were mild to moderate in severity. Mox ifloxacin prolongs the QT interval by a mean + S.D. of 6 +/- 26 millisecond s above baseline and should be used with caution in patients with proarrhyt hmic conditions and avoided in patients receiving antiarrhythmia agents, su ch as quinidine, procainamide, amiodarone, and sotalol. The standard oral d osage is 400 mg once a day. Dosage adjustment is unnecessary in patients wi th renal dysfunction or mild to moderate hepatic dysfunction. Moxifloxacin is a safe and effective antimicrobial that will be useful for treating acute sinusitis, acute bacterial exacerbations of chronic bronchit is, and community-acquired pneumonia.