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gatifloxacin (Tequin, Zymar)

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 - bacterial conjunctivitis [4] - corneal ulcer Contraindications: 1) do NOT use in patients with diabetes mellitus [7] 2) caution in the elderly, renal insufficieny Dosage: 400 mg PO/IV QD Tablets Injection (IV) Ophthalmic: (Zymar) [4] Dosage adjustment in renal failure: 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: -> 1/2life 7-14 hours (36 hours ESRD) Antimicrobial activity: - Gram-positive (activity enhanced) - Streptococcus pneumoniae - Gram negative - Legionella pneumophila [8] - Chlamydophila pneumoniae - Haemophilus influenzae - Haemophilus parainfluenzae - Moraxella catarrhalis - Escherichia coli - Klebsiella - Proteus - atypical - Mycoplasma pneumoniae [8] Adverse effects: 1) may prolong QT interval, but clinically not significant (so far) 2) hypoglycemia (generally within 1st 3 days) [7] 3) hyperglycemia (generally after 3 days) [7] Drug interactions: -> may cause severe hypoglycemia when used in combination with sulfonylureas, repaglinide (Prandin) & other hypoglycemic agents.

Interactions

drug interactions drug adverse effects of fluoroquinolones

Specific

Gatifloxacin Ophthalmic

General

fluoroquinolone

Properties

INHIBITS: DNA gyrase

Database Correlations

PUBCHEM cid=5379

References

  1. Prescriber's Letter 7(2):7, Feb. 2000
  2. Sanford Guide to antimicrobial therapy 2001
  3. Prescriber's Letter 9(11):64 2002
  4. Prescriber's Letter 10(5):27 2003
  5. Department of Veterans Affairs, VA National Formulary
  6. Prescriber's Letter 13(1): 2006 Glucose abnormalities and fluoroquinolones Detail-Document#: 220109 (subscription needed) http://www.prescribersletter.com
  7. 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#: 220315 (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. Deprecated Reference