Moxifloxacin

General

Adult Dosing
  • 400mg PO/IV daily

Pediatric Dosing

Safety/efficacy not established

Special Populations
  • Pregnancy: C
  • Lactation: Unknown
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications
  • Allergy to class/drug

Adverse Reactions

Serious
  • QT prolongation [1]
    • Amongst fluoroquinolones, the risk of arrhythmia is highest with moxifloxacin

Common
  • GI
    • Gastritis [2]
    • C. difficile associated disease [3]

Pharmacology
  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

Antibiotic Sensitivities[4]
  • In general, less activity against pseudomonas than ciprofloxacin, but has more activity against MSSA[5]
  • Compared to levofloxacin, moxifloxacin has greater in vitro activity against strep pneumoniae, staph aureus and some enterococcus strains [6]
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. meningitidisS
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 spS
Serratia marcescensX1
Salmonella spS
Shigella spS
Proteus mirabilisS
Proteus vulgarisS
Providencia sp.S
Morganella sp.S
Citrobacter freundiiS
Citrobacter diversusS
Citrobacter sp.S
Aeromonas spS
Acinetobacter sp.I
Pseudomonas aeruginosaI
Burkholderia cepaciaR
Stenotrophomonas maltophiliaI
Yersinia enterocoliticaS
Francisella tularensisX1
Brucella sp.X1
Legionella sp.S
Pasteurella multocidaS
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spS
Mycoplasm pneumoniaeS
Rickettsia spX1
Mycobacterium aviumX1
AnaerobesActinomycesS
Bacteroides fragilisI
Prevotella melaninogenicaS
Clostridium difficileR
Clostridium (not difficile)I
Fusobacterium necrophorumI
Peptostreptococcus sp.S

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. Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  2. Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  3. Hooper DC. Fluoroquinolones. In: UpToDate. Waltham, MA. www.uptodate.com. Accessed March 23, 2020.
  4. Sanford Guide to Antimicrobial Therapy 2014
  5. Culley C et al. Moxifloxacin: Clinical Efficacy and Safety. Am J Health Syst Pharm. 2001;58(5). http://www.medscape.com/viewarticle/406946_3
  6. Oliphant CM, Green G. Quinolones: A Comprehensive Review. American Family Physician. https://www.aafp.org/afp/2002/0201/p455.html. Published February 1, 2002. Accessed March 23, 2020.
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