antibioticsbooks

98 PART 2 Antibacterial Drugs
Spectrum: ciprofloxacin
Good: enteric GNRs (E. coli, Proteus, Klebsiella,
etc.), Haemophilus influenzae
Moderate: Pseudomonas, atypicals (Mycoplasma,
Chlamydia, Legionella)
Poor: staphylococci, S. pneumoniae, anaerobes,
enterococci
Spectrum: levofloxacin/moxifloxacin/
gemifloxacin
Good: enteric Gram negatives, S. pneumoniae,
atypicals, Haemophilus influenzae
Moderate: Pseudomonas (levofloxacin only),
MSSA
Poor: anaerobes (except moxifloxacin, which
has moderate activity), enterococci
Adverse Effects
Central nervous system: Fluoroquinolones can
cause CNS adverse reactions, including dizziness,
confusion, and hallucinations. Elderly
patients are particularly susceptible to these.
Younger patients may develop insomnia.
Cardiovascular: Prolongation of the QT interval
can be observed, but arrhythmias usually only
occur in patients with other risk factors (underlying
arrhythmia, concomitant proarrhythmic
drug, excessive dose).
Musculoskeletal: Arthralgias (uncommonly) and
Achilles tendon rupture (very rarely) may occur.
Tendon rupture is more common in the elderly,
patients with renal dysfunction, and those taking
corticosteroids.
Dermatologic: Photosensitivity is often seen.
Patients should avoid the sun or use sunscreen
while taking fluoroquinolones.