Moxifloxacin

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

Dosing

400mg IV/PO daily

General Information

Common Usage

  • Pneumonia including CAP, HAP, aspiration

  •  Some intra-abdominal infections

  •  CNS infection

  •  Does not treat UTIs

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

  •  QTc prolongation

  • Dysglycemia

  • CNS toxicity including confusion, psychosis

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • Rash

Major Interactions

QTc prolongation - Increased risk with other agents that prolong QTc

Divalent cations including Ca, Mg - decreased absorption

Warfarin - increased INR

Rifampin - decrease moxifloxacin levels

Additional Information

Does not treat urinary tract infections.

FDA Black Box warning against use in acute bacterial sinusitis, and acute exacerbation of chronic bronchitis where alternatives exist due to serious adverse side effects

May exacerbate muscle weakness in persons with myasthenia gravis. Avoid Use.

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 12.0

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor