CV: QT interval prolongation, AORTIC ANEURYSM/DISSECTION, TORSADES DE POINTES.
Derm: acute generalized exanthematous pustulosis, photosensitivity, rash, STEVENS-JOHNSON SYNDROME.
Endo: hyperglycemia, hypoglycemia.
GI: nausea, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), abdominal pain, diarrhea, HEPATOTOXICITY, vomiting.
GU: vaginitis.
Local: phlebitis at IV site.
MS: arthralgia, myalgia, tendinitis, tendon rupture.
Neuro: agitation, anxiety, confusion, depression, dizziness , ELEVATED INTRACRANIAL PRESSURE (INCLUDING PSEUDOTUMOR CEREBRI), hallucinations, headache, insomnia, lightheadedness, nightmares, paranoia, peripheral neuropathy, SEIZURES, SUICIDAL THOUGHTS/BEHAVIORS, toxic psychosis, tremor.
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS).
Nosocomial Pneumonia
- PO, IV (Adults): 750 mg once daily for 7–14 days.
Community-Acquired Pneumonia
- PO, IV (Adults): Staphylococcus aureus, Streptococcus pneumoniae (including multi-drug resistant strains), Haemophilus influenzae/parainfluenzae, Klebsiella pneumoniae, Moraxella catarrhalis, Chlamydia pneumoniae, Legionella pneumophila, or Mycoplasma pneumoniae: 500 mg once daily for 7–14 days; Streptococcus pneumoniae (not multi-drug resistant strains), Haemophilus influenzae/parainfluenzae, Mycoplasma pneumoniae, or Chlamydia pneumoniae: 750 mg once daily for 5 days.
Skin/Skin Structure Infections
- PO, IV (Adults): Complicated: 750 mg once daily for 7–14 days; Uncomplicated: 500 mg once daily for 7–10 days.
Chronic Bacterial Prostatitis
- PO, IV (Adults): 500 mg once daily for 28 days.
Inhalational Anthrax (Post-Exposure)
- PO, IV (Adults and Children >50 kg): 500 mg once daily for 60 days.
- PO, IV (Children ≥6 mo and <50 kg): 8 mg/kg (max dose = 250 mg) every 12 hr for 60 days.
Plague
- PO, IV (Adults and Children >50 kg): 500 mg once daily for 10–14 days.
- PO, IV (Children ≥6 mo and <50 kg): 8 mg/kg (max dose= 250 mg) every 12 hr for 10–14 days.
Urinary Tract Infections
- PO, IV (Adults): Complicated urinary tract infection due to Enterococcus faecalis, Enterobacter cloacae, E. coli, Klebsiella pneumoniae, Proteus mirabilis, or Pseudomonas aeruginosa or acute pyelonephritis due to E. coli: 250 mg once daily for 10 days; Complicated urinary tract infection due to E. coli, Klebsiella pneumoniae, or Proteus mirabilis, or acute pyelonephritis due to E. coli: 750 mg once daily for 5 days; Uncomplicated: 250 mg once daily for 3 days.
Acute Bacterial Exacerbations of Chronic Bronchitis
- PO, IV (Adults): 500 mg once daily for 7 days.
Acute Sinusitis
- PO, IV (Adults): 500 mg once daily for 10–14 days or 750 mg once daily for 5 days.
Renal Impairment
- PO, IV (Adults): Normal renal function dosing of 750 mg/day: CCr 20–49 mL/min: 750 mg every 48 hr; CCr 10–19 mL/min, hemodialysis, or CAPD: 750 mg initially, then 500 mg every 48 hr; Normal renal function dosing of 500 mg/day: CCr 20–49 mL/min: 500 mg initially then 250 mg every 24 hr; CCr 10–19 mL/min, hemodialysis, or CAPD: 500 mg initially then 250 mg every 48 hr. Normal renal function dosing of 250 mg/day: CCr 10–19 mL/min: 250 mg every 48 hr.
Therapeutic Classification: anti-infectives
Pharmacologic Classification: Fluoroquinolones
Absorption: Well absorbed (99%) after oral administration; IV administration results in complete bioavailability.
Distribution: Widely distributed. High tissue and urinary levels are achieved. Appears to cross the placenta.
Protein Binding: 24–38%.
Metabolism/Excretion: 87% excreted unchanged in urine, small amounts metabolized.
Half-life: 8 hr.
