Gemifloxacin

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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 Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp S
Enterococcus faecalis S
Enterococcus faecium I
MSSA S
MRSA I
CA-MRSA I
Staph. Epidermidis S
C. jeikeium X1
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis X1
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ S
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg S
Enterobacter sp, AmpC pos S
Serratia sp X1
Serratia marcescens X1
Salmonella sp X1
Shigella sp X1
Proteus mirabilis X1
Proteus vulgaris S
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. I
Pseudomonas aeruginosa X1
Burkholderia cepacia X1
Stenotrophomonas maltophilia X1
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. S
Pasteurella multocida X1
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
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

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014