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Third Generation Fluoroquinolone

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Third Generation Fluoroquinolone, Third Generation Quinolone, Levofloxacin, Levaquin, Sparfloxacin, Zagam, Gatifloxacin, Tequin, Moxifloxacin, Avelox

  • See Also
  1. Fluoroquinolone
  • Precautions
  1. QT Prolongation with Levofloxacin (Levaquin)
    1. Three fold increased risk of Sudden Cardiac Death while on Levofloxacin
    2. This appears to be a class effect with most Fluoroquinolones except Ciprofloxacin
    3. Ray (2013) N Engl J Med 366(20): 1881-90 [PubMed]
  • Activity Spectrum
  1. Gram Negative Rod coverage (see other Fluoroquinolones)
    1. Enterobacteriaceae
  2. Atypical Bacteria
  3. Moderate Gram Positive activity
  • Indications
  1. Community Acquired Pneumonia
  2. Refractory acute Bacterial Sinusitis (third line agent)
  • Preparations
  1. Levofloxacin (Levaquin)
  2. Moxifloxacin (Avelox)
    1. Low urine concentrations (avoid in UTI)
    2. No Pseudomonas coverage
    3. Highest risk Quinolone for QT Prolongation
  3. Sparfloxacin (Zagam)
    1. Low urine concentrations (avoid in UTI)
  4. Gatifloxacin (Tequin)
    1. Removed from U.S. market in 2006 due to fatalities (Hypoglycemia related)
  • Adverse Effects
  1. See Fluoroquinolone
  2. Hypoglycemia with Gatifloxacin (Tequin)
    1. Has occurred in non-diabetics
    2. Contraindicated in Diabetes Mellitus
  • References
  1. King (2000) Am Fam Physician 61(9):2741-8 [PubMed]
  2. O'Donnell (2000) Infect Dis Clin North Am 14(2):489-513 [PubMed]
  3. Oliphant (2002) Am Fam Physician 65(3):455-64 [PubMed]
  4. Owens (2000) Med Clin North Am 84(6):1447-69 [PubMed]