Moxifloxacin

General

Adult Dosing

  • 400mg PO/IV daily

Pediatric Dosing

Safety/efficacy not established

Special Populations

  • Pregnancy: C
  • Lactation: Unknown
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • QT prolongation [1]
    • Amongst fluoroquinolones, the risk of arrhythmia is highest with moxifloxacin

Common

  • GI
    • Gastritis [2]
    • C. difficile associated disease [3]

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

Antibiotic Sensitivities[4]

  • In general, less activity against pseudomonas than ciprofloxacin, but has more activity against MSSA[5]
  • Compared to levofloxacin, moxifloxacin has greater in vitro activity against strep pneumoniae, staph aureus and some enterococcus strains [6]
Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium I
MSSA S
MRSA I
CA-MRSA I
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ S
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp S
Serratia marcescens X1
Salmonella sp S
Shigella sp S
Proteus mirabilis S
Proteus vulgaris S
Providencia sp. S
Morganella sp. S
Citrobacter freundii S
Citrobacter diversus S
Citrobacter sp. S
Aeromonas sp S
Acinetobacter sp. I
Pseudomonas aeruginosa I
Burkholderia cepacia R
Stenotrophomonas maltophilia I
Yersinia enterocolitica S
Francisella tularensis X1
Brucella sp. X1
Legionella sp. S
Pasteurella multocida S
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces S
Bacteroides fragilis I
Prevotella melaninogenica S
Clostridium difficile R
Clostridium (not difficile) I
Fusobacterium necrophorum I
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  2. ↑ Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  3. ↑ Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  4. ↑ Sanford Guide to Antimicrobial Therapy 2014
  5. ↑ Culley C et al. Moxifloxacin: Clinical Efficacy and Safety. Am J Health Syst Pharm. 2001;58(5). http://www.medscape.com/viewarticle/406946_3
  6. ↑ Oliphant CM, Green G. Quinolones: A Comprehensive Review. American Family Physician. https://www.aafp.org/afp/2002/0201/p455.html. Published February 1, 2002. Accessed March 23, 2020.
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