Gemifloxacin

General

  • Type: Fluoroquinolone
  • Dosage Forms: Oral (320mg)
  • Common Trade Names: Factive

Adult Dosing

Pneumonia, community-acquired

  • 320 mg PO q24h for at least 5 days

Chronic bronchitis, acute bacterial exacerbation

  • 320 mg PO q24h x5 days

Gonoccocal infection

Pediatric Dosing

  • No current dosing

Special Populations

  • Pregnancy Rating: C; potential for fetotoxicity at higher doses
  • Lactation: L3; no human data available.
  • Renal Dosing
    • Adult
      • CrCl <40: 160mg q24h
      • HD/PD: No supplement
    • Pediatric
      • N/A
  • Hepatic Dosing
    • Adult
      • No adjustment
    • Pediatric
      • N/A

Contraindications

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 7h
  • Metabolism: Liver minimally
  • Excretion: Feces 61%, Urine 36%
  • Mechanism of Action: 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. meningitidisX1
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 spX1
Serratia marcescensX1
Salmonella spX1
Shigella spX1
Proteus mirabilisX1
Proteus vulgarisS
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.I
Pseudomonas aeruginosaX1
Burkholderia cepaciaX1
Stenotrophomonas maltophiliaX1
Yersinia enterocoliticaX1
Francisella tularensisX1
Brucella sp.X1
Legionella sp.S
Pasteurella multocidaX1
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spS
Mycoplasm pneumoniaeS
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesX1
Bacteroides fragilisR
Prevotella melaninogenicaX1
Clostridium difficileX1
Clostridium (not difficile)X1
Fusobacterium necrophorumX1
Peptostreptococcus sp.X1

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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