Quinolones Flashcards
Name the 5 quinolone antibiotics available in the UK
- Ciprofloxacin
- Delafloxacin
- Levofloxacin
- Moxifloxacin
- Ofloxacin
What is the spectrum of activity of ciprofloxacin?
Active against both gram (+) and gram (-) bacteria HOWEVER more activity against gram (-)
Most anaerobes are not susceptible
What are the main gram (-) bacteria targeted by ciprofloxacin? (5)
- Salmonella
- Shigella
- Campylobacter
- Neisseria
- Pseudomonas
Ciprofloxacin has moderate activity against which gram (+) bacteria? (2)
- Strep pneumoniae
- Enterococcus faecalis
**should NOT be used to treat pneumococcal pneumonia; respiratory quinolones offer better protection
Can ciprofloxacin be used against chlamydia?
Yes
Can ciprofloxacin be used against mycobacteria?
SOME mycobacteria
What are the indications of ciprofloxacin? (5)
- Respiratory tract infections (but NOT pneumococcal pneumonia)
- GI infections (including typhoid fever)
- Bone and joint infections
- Gonorrhea
- Septicemia (caused by sensitive organisms)
What are the indications for ofloxacin? (4)
- UTIs
- Lower RTIs
- Gonorrhea
- Non-gonococcal urethritis and cervicitis
Which quinolones are considered “respiratory quinolones?” (2)
Levofloxacin and moxiflocacin due to their increased activity against Pneumococci (compared to ciprofloxacin)
Do quinolones have activity against staph?
Many staph species have developed resistance to quinolones; use of quinolones should be avoided in MRSA infections EXCEPT delafloxacin, which has activity against MRSA
Which quinolones are active against Pseudomonas?
Ciprofloxacin and Levofloxacin
What are the indications for delafloxacin?
- MRSA infection
2. Treatment of acute bacterial skin infections when standard treatment is inappropriate
Which quinolone has activity against MRSA?
Delafloxacin
What are the main adverse effects associated with the use of quinolones? (5)
- Convulsions (patients with or without a history of convulsions; taking NSAIDs at the same time may also induce them)
- Tendon damage (including rupture; may occur within 48 hours from starting treatment as well as several months after stopping treatment)
- Aortic aneurysm and dissection (particularly elderly patients)
- Heart valve regurgitation
- QT prolongation and torsades de pointes
What are the main contraindications of quinolones? (4)
- History of tendon disorders related to quinolone use
- Non-severe or self-limiting infection or non-bacterial conditions
- Pregnancy (except when using a single dose of ciprofloxacin to prevent meningococcal meningitis)
- History of quinolone hypersensitivity