Gatifloxacin

General

  • Type: Fluoroquinolone
  • Dosage Forms: Ophthalmic solution
  • Common Trade Names: Zymar, Zymaxid

Adult Dosing

  • 0.3% solution, 1 gtt in eye q2h up to 8x/day day 1 and 2, then QID x 5 days
  • 0.5% solution, 1 gtt in eye q2h up to 8x/day first day, then bid-QID x 6 days

Pediatric Dosing

  • > 1 y/o
    • 0.3% solution, 1 gtt in eye q2h up to 8x/day day 1 and 2, then QID x 5 days
    • 0.5% solution, 1 gtt in eye q2h up to 8x/day first day, then bid-QID x 6 days

Special Populations

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

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Conjunctival hemorrhage
  • Superinfection

Hypersensitivity reaction

Common

  • Conjunctival irritation
  • Ocular irritation
  • Dysgeusia
  • Ocular pain
  • Chemosis
  • Dry eyes
  • Ocular discharge
  • Blepharitis
  • Headache
  • Visual acuity changes

Pharmacology

  • Half-life: N/A (7-14 hours for systemic preparations)
  • Metabolism: Minimal
  • Excretion: N/A (urine for systemic preparations)
  • Mechanism of Action: Bactericidal, inhibits DNA gyrase and topoisomerase IV

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepS
Strep. anginosus gpS
Enterococcus faecalisS
Enterococcus faeciumI
MSSAS
MRSAI
CA-MRSAI
Staph. EpidermidisS
C. jeikeiumX1
L. monocytogenesS
Gram NegativesN. gonorrhoeaeI
N. meningitidisS
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+S
E coli/Klebsiella KPC+R
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posS
Serratia spS
Serratia marcescensX1
Salmonella spS
Shigella spS
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.S
Citrobacter freundiiS
Citrobacter diversusS
Citrobacter sp.S
Aeromonas spS
Acinetobacter sp.I
Pseudomonas aeruginosaI
Burkholderia cepaciaR
Stenotrophomonas maltophiliaI
Yersinia enterocoliticaS
Francisella tularensisX1
Brucella sp.X1
Legionella sp.S
Pasteurella multocidaS
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spS
Mycoplasm pneumoniaeS
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesS
Bacteroides fragilisI
Prevotella melaninogenicaS
Clostridium difficileR
Clostridium (not difficile)S
Fusobacterium necrophorumX1
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

References

  1. Sanford Guide to Antimicrobial Therapy 2014
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