MedWorm: Avelox

  Bacterial conjunctivitis

New evidence; conclusion confirmed for: Empirical treatment with topical antibiotics in people with suspected bacterial conjunctivitis One RCT with weak methods added comparing moxifloxacin versus combination trimethoprim/polymyxin. The RCT found that moxifloxacin increased clinical and microbiological cure rates compared with trimethoprim/polymyxin, which ran contrary to findings of multiple other RCTs that found equivalent effectiveness for these outcomes when different antibiotics were compared with each other. Categorisation unchanged (Likely to be beneficial). Antibiotics (topical) in people with culture-positive non-gonococcal bacterial conjunctivitis Five RCTs added. The first three RCTs compared top...

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  Avelox 400mg/250 mL solution for infusion (New formulation)

Source: Manufacturer notification Area: Other Library Updates > SPC Changes Avelox (Moxifloxacin) IV granted UK licence for the treatment of community-acquired pneumonia and complicated skin and skin structure infections. Moxifloxacin should be used only when it is considered inappropriate to use antibacterial agents that are commonly recommended for the initial treatment of these infections.               (Source: NeLM - SPC Changes)

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  Efficacy and safety of besifloxacin ophthalmic suspension 0.6% in children and adolescents with bacterial conjunctivitis: a post hoc, subgroup analysis of three randomized, double-masked, parallel-group, multicenter clinical trials.

Authors: Comstock TL, Paterno MR, Usner DW, Pichichero ME Acute conjunctivitis is the most frequent eye disorder seen by primary care physicians and one that often affects children. Besifloxacin is a new topical fluoroquinolone, the first chlorofluoroquinolone, for the treatment of bacterial conjunctivitis. To examine the efficacy and safety of besifloxacin ophthalmic suspension 0.6% in patients aged 1-17 years with bacterial conjunctivitis. This was a post hoc analysis of a subgroup of pediatric patients aged 1-17 years who had participated in three previously reported, randomized, double-masked, parallel-group, multicenter, clinical trials evaluating the safety and efficacy of besifloxacin in the treatment of bacterial conjunctivitis. The studies were conducted in a community setting...

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  Pulsed Moxifloxacin for the Prevention of Exacerbations of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

This proof-of-concept study evaluates whether intermittent pulsed moxifloxacin treatment could reduce the frequency of acute exacerbations in COPD. Respiratory Research (Source: Medscape Pharmacist Headlines)

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  Molecular characterization of moxifloxacin resistance from Canadian Clostridium difficile clinical isolates

Abstract: Fluoroquinolone resistance in Clostridium difficile has been implicated in recent outbreaks of C. difficile infection. The purpose of this report was to characterize the molecular mechanism conferring resistance to moxifloxacin among C. difficile clinical isolates. Eighty-four C. difficile clinical isolates (collected as part of the Canadian Nosocomial Infection Surveillance Program) were evaluated in the current study. Pulsed-field gel electrophoresis was used to type the isolates. Susceptibility testing was performed using Clinical and Laboratory Standards Institute agar dilution methods. The quinolone resistance-determining region of both gyrA and gyrB was amplified using polymerase chain reaction and sequenced for each isolate. The proportion of isolates studied by the North ...

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  AVELOX (Moxifloxacin Hydrochloride) Injection, Solution AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Schering Plough Corporation]

Updated Date: Mar 12, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Bayer Schering Pharma launches moxifloxacin solution for infusion in the UK

Source: Personal Communication Area: News Bayer Schering Pharma has launched moxifloxacin hydrochloride 400 mg/250 mL solution for infusion (Avelox®) for the treatment of:   - Community acquired pneumonia (CAP) - Complicated skin and skin structure infections (cSSSI)   Please see link below for full prescribing information in the SPC.   The cost of one pack containing 5 bottles is £199.75 (Source: NeLM - News)

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  Effects of the Selective alpha(1A)-Adrenoceptor Antagonist Silodosin on ECGs of Healthy Men in a Randomized, Double-Blind, Placebo- and Moxifloxacin-Controlled Study.

Authors: Morganroth J, Lepor H, Hill LA, Volinn W, Hoel G In order to determine the effects of therapeutic and supratherapeutic doses of silodosin on QT interval, healthy men (N = 186; aged 18-45 years) were randomized to receive silodosin (8 or 24 mg) or placebo for 5 days or moxifloxacin 400 mg (positive control, known to prolong QT) once on day 5. At baseline and on day 5, five ECGs were recorded 0.25 h before dosing and 1, 1.5, 2, 3, 4, 6, 8, 10, and 23.5 h after dosing. Adjusted mean differences (analysis of covariance) between silodosin and placebo in the change in individual heart rate-corrected QTc (QTcI) from baseline to day 5 were <5 ms at all times (all 90% confidence interval (CI) upper limits <10 ms). The QTcI difference for moxifloxacin compared with placebo often e...

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  A comparison of treatment outcomes for moxifloxacin versus ofloxacin/metronidazole for first-line treatment of uncomplicated non-gonococcal pelvic inflammatory disease

This study compares the clinical outcome and tolerability of treatment with moxifloxacin 400 mg once a day or ofloxacin 400 mg plus metronidazole 400 mg both twice daily in patients diagnosed with PID. A retrospective case-notes review was performed on patients diagnosed clinically with PID before and after local guidelines were changed to recommend moxifloxacin as first-line treatment for uncomplicated PID. Before the guidelines changed, 114/134 (85%) patients received the recommended first-line therapy versus 206/257 (80%) after the change, P = 0.3. There was no difference in the clinical outcomes between the two groups; significant improvement/resolved 77% versus 70%; marginal improvement 3% versus 11%; no change/worse 20% versus 18%, P = 0.14. Moxifloxacin is confirmed to be an effecti...

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  Pharmacokinetics and Bioavailability of Moxifloxacin in Calves following Different Routes of Administrations

Chemotherapy 2010;56:26–31 (DOI:10.1159/000290172) (Source: Chemotherapy)

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  Moxifloxacin: Uveitis-like syndrome and first report of iris transillumination: 5 case reports

(Source: Reactions)

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  Erratum

In the December issue, in the article “Preoperative Topical Moxifloxacin 0.5% and Povidone–Iodine 5.0% Versus Povidone–Iodine 5.0% Alone to Reduce Bacterial Colonization in the Conjunctival Sac” (J Cataract Refract Surg 2009;35:2109-2114), the name of the first author is spelled incorrectly. The correct name of the first author is Orly Halachmi-Eyal, MD. (Source: Journal of Cataract and Refractive Surgery)

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  AVELOX ABC PACK (Moxifloxacin Hydrochloride) Tablet, Film Coated [Stat Rx USA]

Updated Date: Feb 26, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Intermittent moxifloxacin treatment may help prevent COPD exacerbations

Intermittent pulsed moxifloxacin treatment may help reduce the risk for exacerbations in patients with chronic obstructive pulmonary disease, a study suggests. (Source: MedWire News - Respiratory)

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  In Vitro Antibacterial Activities of JNJ-Q2, a New Broad-Spectrum Fluoroquinolone.

In conclusion, JNJ-Q2 exhibits a range of antibacterial activity in vitro that is supportive of its further evaluation as a potential new agent for the treatment of skin and respiratory tract infections. PMID: 20176911 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Physicians Total Care, Inc.]

Updated Date: Feb 19, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Comparison of fluoroquinolone kinetics of kill in susceptible and resistant Gram-positive conjunctival pathogens.

CONCLUSION: Moxifloxacin showed an increased speed of kill against both of the common susceptible Gram-positive conjunctival pathogens, compared with the inconsistency of killing activity of two other fluoroquinolones tested. In addition, at the concentration level achieved in the conjunctiva after the instillation of one drop, moxifloxacin effectively and rapidly killed resistant Gram-positive conjunctival pathogens, while ciprofloxacin and ofloxacin had no effect against these organisms. PMID: 20174904 [PubMed - as supplied by publisher] (Source: Advances in Therapy)

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  Studies on Poloxamer Based Mucoadhesive Insitu Ophthalmic Hydrogel of Moxifloxacin HCL.

Authors: Shastri DH, Prajapati ST, Patel LD Conventional eye drops shows relatively low bioavailability due to poor precorneal contact time. In situ hydrogels are of great importance in providing sustained ocular drug delivery due to their elastic properties hydrogels resist ocular drainage leading to longer contact times. In the present study an in situ gelling thermoreversible mucoadhesive gel was formulated of an antibacterial agent Moxifloxacin HCl using combination of poloxamer 407 and poloxamer 188 with different mucoadhesive polymers such as Xanthan gum and Sodium alginate with a view to increase in gel strength and bioadhesion force and thereby increase in precorneal contact time and there by increase in bioavailability of the drug. The formulations were evaluated for physical ...

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  A fast standardized therapeutic efficacy assay for drug discovery in tuberculosis.

Authors: Rullas J, García JI, Beltrán M, Cardona PJ, Cáceres N, García-Bustos JF, Angulo-Barturen I Murine models of M. tuberculosis are essential tools in drug discovery. Here we describe a fast standardized 9-day acute assay intended to measure the efficacy of drugs against M. tuberculosis growing in the lungs of immunocompetent mice. This assay is highly reproducible, allows good throughput and was validated for drug lead optimization using isoniazid, rifampicin, ethambutol, pyrazinamide, linezolid, and moxifloxacin. PMID: 20160054 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Ciprofloxacin/moxifloxacin: Tendon rupture exacerbated by concomitant corticosteroids: case report

(Source: Reactions)

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  Moxifloxacin: Drug hypersensitivity syndrome with features of toxic epidermal necrolysis: case report

(Source: Reactions)

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  Contribution of reactive oxygen species to pathways of quinolone-mediated bacterial cell death

Conclusions Inhibitor studies indicated that hydroxyl radical action contributes to quinolone-mediated cell death occurring via the chloramphenicol-sensitive lethal pathway but not via the chloramphenicol-insensitive pathway. (Source: Journal of Antimicrobial Chemotherapy)

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  Characterisation of Exacerbations of Chronic Bronchitis and COPD in Europe: The GIANT Study

The GIANT study collected information on patients with acute exacerbations of chronic bronchitis (AECB) and COPD, and the effect of treatment with moxifloxacin. Therapeutic Advances in Respiratory Disease (Source: Medscape Today Headlines)

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  Pharmacokinetics and Pharmacodynamics of Three Moxifloxacin Dosage Forms: Implications for Blinding in Active-Controlled Cardiac Repolarization Studies.

Authors: Mason JW, Florian JA, Garnett CE, Moon TE, Selness DS, Spaulding RR Moxifloxacin is used in thorough QT studies to assess sensitivity for detection of an increase in QTc. Moxifloxacin is usually over-encapsulated for blinding. However, there is concern that over-encapsulation alters its pharmacokinetics. In a 4-arm, randomized crossover study, 22 volunteers received over-encapsulated moxifloxacin, over-encapsulated placebo, bare moxifloxacin, and intravenous (IV) moxifloxacin. Placebo capsules and IV infusions were administered so that treatments in each arm, except for bare moxifloxacin, were indistinguishable. Pharmacokinetics of the oral treatments were found to be nearly identical and to meet Food and Drug Administration criteria for bioequivalency. Relative to the IV infu...

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  Aspergillus keratitis in vernal shield ulcer—a case report and review

Abstract  An unusual case of vernal shield ulcer with superadded fungal keratitis caused by Aspergillus fumigates is reported. A 26-year-old man, a known case of vernal keratoconjunctivitis (VKC) presented with the complaint of diminution of vision in the right eye. Patient was on topical steroids and anti-allergic treatment for the past two months. In the right eye, a shield ulcer with an elevated plaque was seen. Scrapings from the right cornea revealed fungal filaments on a wet KOH mount and culture revealed growth of Aspergillus fumigatus. The patient was diagnosed as VKC with shield ulcer with secondary fungal keratitis. The patient was treated with topical cyclosporine, topical moxifloxacin, topical natamycin, and topical amphotericin eye drops. The patient responded we...

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  Synthesis and antitubercular evaluation of new fluoroquinolone derivatives coupled with carbohydrates.

We describe in this work the synthesis of nine new fluoroquinolone derivatives based on modifications at the C-7 position of the known fluoroquinolones cipro-, gati-, and moxifloxacin, as well as their antitubercular evaluation. The synthesis of these new analogues was improved using microwave irradiation, providing several advantages such as better yields and shorter reaction times, in comparison with classical reaction conditions. Derivatives 4, 5, and 7 exhibited promising antitubercular activities. PMID: 20167309 [PubMed - as supplied by publisher] (Source: Carbohydrate Research)

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  The effect of moxifloxacin treatment on fluoroquinolone susceptibility of the major pathogenic species in bacterial conjunctivitis

Introduction: A clinical study was conducted in children to test whether topical moxifloxacin therapy for bacterial conjunctivitis changed the fluoroquinolone (FQ) susceptibility of bacteria in eyes (E), on the cheeks (C), in the nares (N), and in the throat (T). (Source: Journal of AAPOS)

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  Pulsed moxifloxacin for the prevention of exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial

Background: Acute exacerbations contribute to the morbidity and mortality associated with chronic obstructive pulmonary disease (COPD). This proof-of-concept study evaluates whether intermittent pulsed moxifloxacin treatment could reduce the frequency of these exacerbations. Methods: Stable patients with COPD were randomized in a double-blind, placebo-controlled trial to receive moxifloxacin 400 mg PO once daily (N=573) or placebo (N=584) once a day for 5 days. Treatment was repeated every 8 weeks for a total of 6 courses. Patients were repeatedly assessed clinically and microbiologically during the 48-week treatment period, and for a further 24 weeks' follow-up. Results: At 48 weeks the odds ratio (OR) for suffering an exacerbation favored moxifloxacin: per-protocol (PP) population (N=738...

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  Single Therapeutic and Supratherapeutic Doses of Laropiprant, a Selective Prostaglandin D2 Receptor 1 Antagonist, Do Not Prolong the QTcF Interval in Healthy Volunteers.

In conclusion, single doses of LRPT 50 mg and 600 mg do not prolong the QTcF interval relative to placebo and are generally well tolerated. PMID: 20107202 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Pharmacology)

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  Effects of Milnacipran on Cardiac Repolarization in Healthy Participants.

Authors: Periclou A, Palmer RH, Zheng H, Lindamood C Milnacipran is approved for management of fibromyalgia in the United States. In this double-blind, placebo-and active drug-controlled study (N = 100), effects of supratherapeutic doses of milnacipran on cardiac repolarization were evaluated in healthy volunteers. The primary outcome was the largest mean difference between milnacipran and placebo in time-matched baseline-adjusted QT interval corrected for heart rate using an individual correction formula (QTcNi). In addition, data were analyzed using the Fridericia formula (QTcF) and a post hoc piecewise QTcNi analysis based on a dichotomous cut of RR interval data at 800 ms. Moxifloxacin (400 mg single dose) was used to establish assay sensitivity. Using the QTcNi method, the largest...

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  Moxifloxacin May Be Better For COPD Outpatients According To New Research Published In The International Journal Of COPD

The objectives of treatment are to decrease the burden of the disease through relief of symptoms, improvement of exercise tolerance, and prevention and treatment of exacerbations... (Source: Health News from Medical News Today)

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  Moxifloxacin May Be Better For COPD Outpatients According To New Research Published In The International Journal Of COPD

The objectives of treatment are to decrease the burden of the disease through relief of symptoms, improvement of exercise tolerance, and prevention and treatment of exacerbations... (Source: Asthma / Respiratory News From Medical News Today)

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  Absence of Pharmacokinetic Interference of Moxifloxacin on Cyclosporine and Tacrolimus in Kidney Transplant Recipients.

This study investigates the potential pharmacokinetic interactions between an antimicrobial agent, moxifloxacin, and 2 immunosuppressant drugs, cyclosporine and tacrolimus, in kidney transplant recipients. Twenty-two kidney transplant patients needing antibiotic therapy for urinary tract infections are enrolled. Eleven patients are under cyclosporine treatment and the other 11 patients are under tacrolimus treatment. Because the urinary tract infections are caused by gram-negative aerobes sensitive to moxifloxacin, this antibiotic is administered by oral route at a dose of 400 mg/d for 1 week; in each patient pharmacokinetic studies are carried out before and at the seventh day of therapy. For both immunosuppressors, none of the pharmacokinetic parameters investigated show statistically si...

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  New susceptibility breakpoints for first line antituberculosis drugs, based on antimicrobial PK/PD science and population pharmacokinetic variability.

Authors: Gumbo T Arguably, one of the most common and consequential laboratory tests performed in the world is Mycobacterium tuberculosis susceptibility testing. M. tuberculosis resistance is defined by growth of >/=1% of bacillary inoculum on critical concentration of an antibiotic. The critical concentration was chosen based on inhibition of >/=95% of wild type isolates. Critical concentrations of isoniazid are either 0.2 or 1.0 mg/L, rifampin 1.0 mg/L, pyrazinamide 100 mg/L, ethambutol 5.0 mg/L, and fluoroquinolones 1.0 mg/L. However, the relevance of these concentrations to microbiologic and clinical outcomes is unclear. Critical concentrations were identified using the ability to achieve the antibiotic area under the concentration-time curve to minimum inhibitory concentrati...

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  Systemic anaphylaxis caused by moxifloxacin.

Authors: Sánchez-Morillas L, Rojas Pérez-Ezquerra P, Reaño-Martos M, Laguna-Martínez JJ, Gómez-Tembleque P PMID: 20089346 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)

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  Comparison of antifungal efficacies of moxifloxacin, liposomal amphotericin B, and combination treatment in experimental Candida albicans endophthalmitis in rabbits

Yudum Tiftikcioğlu Deren, Şengül Özdek, Ayşe Kalkanci, Nalan Akyürek, and Berati Hasanreisoğlu - The goal of this study was to compare in vitro and in vivo efficacy of moxifloxacin and liposomal amphotericin B (Amp-B) monotherapies and combination treatment... (Source: Canadian Journal of Microbiology)

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  Comparative in Vitro Activities of Nemonoxacin (TG-873870), a Novel Nonfluorinated Quinolone, and Other Quinolones against Clinical Isolates.

Authors: Lauderdale TL, Shiau YR, Lai JF, Chen HC, King CH The in vitro antibacterial activities of nemonoxacin (TG-873870), a novel nonfluorinated quinolone, against 770 clinical isolates were investigated. Nemonoxacin (tested as its malate salt, TG-875649) showed better in vitro activity than ciprofloxacin and levofloxacin against different species of staphylococci, streptococci, and enterococci, and Neisseria gonorrhoeae and Haemophilus influenzae. The in vitro activity of TG-875649 was also comparable to or better than moxifloxacin against these pathogens including ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus and levofloxacin-resistant Streptococcus pneumoniae. PMID: 20065058 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemothera...

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  Surveillance and Correlation of Antibiotic Prescription and Gram-Negative Resistance in Singapore Hospitals.

In conclusion, our data demonstrated correlation between prescription of and gram-negative resistance to several but not all key antimicrobial agents in Singapore hospitals. In areas where gram-negative resistance is endemic and prescription of broad-spectrum antimicrobial agents is high, factors other than antimicrobial usage may be equally important in maintaining high resistance rates. PMID: 20065055 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Activity of various drugs alone or in combination against Mycobacterium fortuitum

The objective of this study was to screen a large number of drug combinations in order to evaluate the activity of classical and new potentially useful antibiotics against M. fortuitum. Twenty M. fortuitum clinical isolates were studied with 51 combinations of two drugs and 47 combinations of three drugs belonging to different families: fluoroquinolones, linezolid, macrolides, rifamycins, aminoglycosides, and carbapenems. Activity was determined in Mueller Hinton broth by seeing whether the cultures were negative after 4 days of incubation with the combination of antibiotics. The most active drugs were moxifloxacin and gatifloxacin, which were active against 15 of the 20 strains studied, followed by amikacin (14 of the 20). The combinations of gatifloxacin with rifampicin or rifa...

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  Sequential bilateral lung resection in a patient with Mycobacterium abscessus lung disease refractory to medical treatment.

Authors: Lee SH, Min JW, Um SW, Han SS, Han SK, Shim YS, Yim JJ Mycobacterium abscessus (M. abscessus) is the second most common nontuberculous mycobacteria (NTM) in South Korea. Nevertheless, the diagnosis and treatment of M. abscessus lung disease can be problematic. Surgical resection has been tried for patients with localized M. abscessus lung disease refractory to medical treatment. Here, we report on a 25-year-old woman with M. abscessus lung disease who had been diagnosed and treated three times for pulmonary tuberculosis. She was initially diagnosed as having M. intracellulare lung disease; however, M. abscessus was isolated after several months of medication. She had multiple bronchiectatic and cavitary lesions bilaterally, and M. abscessus was repeatedly isolated from her spu...

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  Avelox (Moxifloxacin HCL) - updated on RxList

Avelox (Moxifloxacin HCL) drug description - FDA approved labeling for prescription drugs and medications at RxList (Source: RxList - New and Updated Drug Monographs)

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  Authors’ Reply Regarding A Letter to the Editor By Lane et al. Concerning Association Between Moxifloxacin Ophthalmic Solution and Fungal Infection in Patients With Corneal Ulcers and Microbial Keratitis

Journal of Ocular Pharmacology and Therapeutics Dec 2009, Vol. 25, No. 6: 573-576. (Source: Journal of Ocular Pharmacology and Therapeutics)

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  Association Between Moxifloxacin Ophthalmic Solution and Fungal Infection in Patients With Corneal Ulcers and Microbial Keratitis

Journal of Ocular Pharmacology and Therapeutics Dec 2009, Vol. 25, No. 6: 571-572. (Source: Journal of Ocular Pharmacology and Therapeutics)

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  Molecular screening for rifampicin and fluoroquinolone resistance in a clinical population of Brucella melitensis

Conclusions The absence of rpoB mutations clearly related to rifampicin resistance in clinical B. melitensis strains reinforces the first-choice status of this antibiotic in the treatment of first brucellosis episodes, and demonstrates the usefulness of molecular screening for resistant genotypes. The absence of topoisomerase II–IV mutations, however, cannot rule out fluoroquinolone resistance due to the interplay of different mechanisms. (Source: Journal of Antimicrobial Chemotherapy)

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  Moxifloxacin increases anti-tumor and anti-angiogenic activity of irinotecan in human xenograft tumors.

Authors: Reuveni D, Halperin D, Fabian I, Tsarfaty G, Askenasy N, Shalit I Camptothecins (CPTs) are topoisomerase I inhibitors chemotherapeutic agents used in combination chemotherapy. We showed previously that combination of moxifloxacin (MXF) and CPT induced inhibitory effects on topoisomerase I activity, on proliferation of HT-29 cells in vitro and enhanced apoptosis, compared to CPT alone. Analysis of secretion of the pro-angiogenic factors IL-8 and VEGF showed significant reduction by MXF. Using a murine model of human colon carcinoma xenograft, we compared the effects of MXF/CPT in vitro to MXF/irinotecan combination in vivo. We show that the MXF/CPT inhibitory effects observed in vitro are reflected in the inhibition of the progressive growth of HT-29 cells implanted in SCID mic...

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  AVELOX (Moxifloxacin Hydrochloride) Injection, Solution AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Schering Plough Corporation]

Updated Date: Dec 11, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Effects of Prulifloxacin on Cardiac Repolarization in Healthy Subjects: A Randomized, Crossover, Double-Blind versus Placebo, Moxifloxacin-Controlled Study

(Source: Clinical Drug Investigation)

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  Interactions between warfarin and three commonly prescribed fluoroquinolones

Source: DARE Area: Evidence > Medication Safety CRD Summary: This review evaluated a potential increased anticoagulant response during concomitant therapy of warfarin and three commonly prescribed fluoroquinolones. Due to inconsistent findings, the authors concluded that there was insufficient evidence to support a potential increased anticoagulant response. The authors' conclusions were appropriate, but should be considered in the context of the review's methodological weaknesses. [The use of ciprofloxacin was reported in 11 studies, levofloxacin in seven studies and moxifloxacin in three studies.] CRD Commentary: This review addressed a clear question and was supported by appropriate inclusion criteria. The authors searched relevant databases and efforts were made to identify additi...

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  Microbiological analysis of epidermal growth factor receptor inhibitor therapy-associated paronychia

Conclusion Empirical oral antibiotic treatment may be performed with oral cephalosporines, ciprofloxacin, levofloxacin or moxifloxacin, as these antimicrobials have high in vitro activity against the majority of the isolated microorganisms and reach high concentrations in the relevant tissue. (Source: Journal of the European Academy of Dermatology and Venereology)

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  A comparison of culture-positive and culture-negative healthcare-associated pneumonia.

CONCLUSION: In this analysis, CN HCAP patients had lower severity of illness, hospital mortality, and hospital length of stay compared to CP patients. These data suggest that CN HCAP patients differ substantially from HCAP patients with positive microbiologic cultures. PMID: 19965954 [PubMed - as supplied by publisher] (Source: Chest)

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  Modulation of metalloproteinase activity in tuberculosis by Interleukin-17 and anti-tuberculous drugs

Tuberculosis kills 2 million people every year. Matrix Metalloproteinases (MMPs) are implicated in tuberculous tissue destruction. We investigated the effect of the Th17 cytokine, Interleukin-17, which contributes to anti-mycobacterial immunity, on MMPs in an in vitro model. Primary airway epithelial cells were stimulated with Interleukin-17, with or without CoMTB (conditioned medium from TB infected monocytes). CoMTB and Interleukin-17 synergistically up-regulated MMP-1 (interstitial collagenase) and MMP-3 (stromelysin) secretion. In contrast, Interleukin-17 down-regulated MMP-9 (gelatinase) secretion. On western analysis, IL-17 drove AkT (Protein Kinase B) phosphorylation. Interleukin-17 and CoMTB driven MMP-3 secretion was abolished by chemical inhibition of the Pi3Kinase pathway and fu...

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  The Missing Link - recurrent lymph node enlargement and abscesses in an HIV negative female receiving chemotherapy for fully sensitive Mycobacterium Tuberculosis

We present of a case of non-resolving Mycobacterium Tuberculosis infection in an HIV negative female with no significant past medical history. Following a non-specific febrile presentation investigations revealed thoracic lymphadenopathy and fully sensitive Mycobacterium Tuberculosis was grown from bronchoalveolar lavage. She did not improve with quadruple therapy and despite the transient addition of steroids and the extension of her therapy to include Clarithromycin and Moxifloxacin she continued to develop lymph node enlargement and abscesses at multiple sites that were AFB positive on microscopy but culture negative. Immunological tests were performed following a year of treatment to assess her TH1 response; cytokine quantification following whole blood stimulation showed markedly redu...

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  The Missing Link - recurrent lymph node enlargement and abscesses in an HIV negative female receiving chemotherapy for fully sensitive Mycobacterium Tuberculosis. Covering letter

We present of a case of non-resolving Mycobacterium Tuberculosis infection in an HIV negative female with no significant past medical history. Following a non-specific febrile presentation investigations revealed thoracic lymphadenopathy and fully sensitive Mycobacterium Tuberculosis was grown from bronchoalveolar lavage. She did not improve with quadruple therapy and despite the transient addition of steroids and the extension of her therapy to include Clarithromycin and Moxifloxacin she continued to develop lymph node enlargement and abscesses that were AFB positive on microscopy but culture negative. Immunological tests were performed following a year of treatment to assess her TH1 response and cytokine quantification following whole blood stimulation showed markedly reduced interferon ...

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  Effects of moxifloxacin and clinafloxacin on murine limb buds cultured in regular and in magnesium-deficient medium.

In conclusion, the effects of moxifloxacin on murine limb buds in vitro were definitely less pronounced than those of clinafloxacin. Effects on growth and differentiation occurred with moxifloxacin only at concentrations that are higher than plasma concentrations observed during therapy. This result is of special interest, because due to rapid metabolism of moxifloxacin in rats results from a routinely performed segment II type study cannot be used for a risk assessment. PMID: 19949773 [PubMed - as supplied by publisher] (Source: Archives of Toxicology)

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  Preoperative topical moxifloxacin 0.5% and povidone–iodine 5.0% versus povidone–iodine 5.0% alone to reduce bacterial colonization in the conjunctival sac

Conclusions: Treatment with povidone–iodine 5.0% alone was effective in preoperative reduction of conjunctival bacterial colonization. Adding topical moxifloxacin 0.5% to povidone–iodine 5.0% had no significant effect on further reduction in the bacterial colonization rate. (Source: Journal of Cataract and Refractive Surgery)

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  Effect of cefuroxime and moxifloxacin on Staphylococcus epidermidis adherence to intraocular lenses.

Conclusion: Our results suggest that moxifloxacin and cefuroxime significantly inhibit bacterial adherence to IOLs. The effect of moxifloxacin on inhibition of bacterial adherence was significantly greater than that of cefuroxime. For this reason moxifloxacin might be considered as a better prophylactic agent. PMID: 20029484 [PubMed - in process] (Source: Canadian Journal of Ophthalmology)

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  The influence of antibiotics on the changing epidemiology of Clostridium difficile.

Authors: Taori SK, Hall V, Poxton I An increase in incidence of clinical cases of Clostridium difficile infection has been reported in recent years but few studies have examined the changes in molecular epidemiology and antibiotic resistance over a long period of time. A collection of 179 isolates of C. difficile obtained from symptomatic adult patients in southern Scotland between 1979 and 2004 was used to determine changes in the prevalence of epidemiological types and antibiotic susceptibilities to common antibiotics. PCR ribotyping and MICs were performed on all isolates. A total of 56 different ribotypes was identified among which ribotype 002 was the commonest type overall (14%), followed by ribotypes 014 (7.3%), 012 (5%), 015 (5%), 020(5%), and 001 (4.5%). Ribotype 078 was also ...

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  Neglected Diseases Caused By Bacterial Infections.

Authors: Bechtle M, Chen S, Efferth T Bacterial infections represent a major health problem, especially in third world countries. In endemic regions, large populations of people are greatly affected, but the medical care is very limited. In this review, the neglected diseases buruli ulcer and trachoma are elucidated. Buruli ulcer is caused by Mycobacterium ulcerans which produces an outstanding immunosuppressive toxin mycolactone that induces an ulcerative, necrotic skin disease. Until today, only the combination of rifampin/streptomycin is used to treat buruli ulcer. However, this therapy is ineffective and expensive. Here, we report new findings that suggest pharmaceutical formulations such as rifapentine, in combination with clarithromycin or moxifloxacin that have shown promising r...

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  Levofloxacin can be used effectively as a positive control in thorough QT/QTc studies in healthy volunteers

CONCLUSIONS Both levofloxacin and moxifloxacin can fulfil the criteria for a positive comparator. The ICH E14 guidelines recommend a threshold of around 5 ms for a positive QT/QTc study. The largest time-matched difference in QTc for levofloxacin suggests the potential for use in more rigorous QT/QTc studies. This study has demonstrated the utility of levofloxacin on the assay in measuring mean QTc changes around 5 ms. (Source: British Journal of Clinical Pharmacology)

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  No cardiac effects of therapeutic and supratherapeutic doses of rupatadine: results from a 'thorough QT/QTc study' performed according to ICH guidelines

CONCLUSIONS This 'thorough QT/QTc study' confirmed previous experience with rupatadine and demonstrated that it had no proarrhythmic potential and raised no concerns regarding its cardiac safety. (Source: British Journal of Clinical Pharmacology)

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  Staphylococcus aureus Endophthalmitis: Antibiotic Susceptibilities, Methicillin Resistance, and Clinical Outcomes

Conclusions: Although all MSSA and MRSA isolates were sensitive to vancomycin, fewer than half of MRSA isolates were sensitive to the fourth-generation fluoroquinolones. Visual acuity outcomes between MRSA and MSSA eyes were not significantly different. (Source: American Journal of Ophthalmology)

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  Determination of the mutant selection window for clindamycin, doxycycline, linezolid, moxifloxacin and trimethoprim/sulfamethoxazole against community-associated meticillin-resistant Staphylococcus aureus (MRSA)

In this study, mutant prevention concentration (MPC) testing was used to investigate the propensity for future resistance induction in CA-MRSA by clindamycin, doxycycline, linezolid, moxifloxacin and trimethoprim/sulfamethoxazole. Four CA-MRSA isolates [two each of clones USA300 (10841 and NRS384) and USA400 (2833 and NRS123)] were tested as well as a single hospital-acquired strain (NRS385). A variable hierarchy of the tested antimicrobials with respect to the percentage of the dosage interval that concentrations fall within the mutant selection window (%TMSW) was determined, with all antimicrobials achieving %TMSW values >20%. Against the hospital-acquired strain, all antimicrobials except linezolid (%TMSW=74.10%) and moxifloxacin (%TMSW=21.65%) are predicted to attain concentrations bel...

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  The Newer Fluoroquinolones

This article reviews fluoroquinolone pharmacology, pharmacodynamic principles, and fluoroquinolone resistance mechanisms, highlighting recent trends in the epidemiology of fluoroquinolone resistance among gram-negative organisms and Streptococcus pneumonia. Important fluoroquinolone safety concerns are discussed, along with indications for the most commonly used fluoroquinolones—ciprofloxacin, levofloxacin, and moxifloxacin. (Source: Infectious Diseases Clinics of North America)

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  In vitro susceptibility of bacterial keratitis isolates to fourth-generation fluooquinolones.

Conclusions. Monotherapy with moxifloxacin or gatifloxacin can be an effective alternative to cefazolin-tobramycin combination as a first-line empirical therapy for bacterial keratitis. The addition of cefazolin to a fourth-generation fluoroquinolone is of limited value. PMID: 19924668 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

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  In vitro activity of nemonoxacin (TG-873870), a novel non-fluorinated quinolone, against clinical isolates of Staphylococcus aureus, enterococci and Streptococcus pneumoniae with various resistance phenotypes in Taiwan

Conclusions Our findings point to a potentially useful role for nemonoxacin in the treatment of infections caused by MSSA, ciprofloxacin-susceptible MRSA and S. pneumoniae with various resistance phenotypes. (Source: Journal of Antimicrobial Chemotherapy)

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  Electrocardiographic Characterization of the QTc Interval in Patients with Advanced Solid Tumors: Pharmacokinetic- Pharmacodynamic Evaluation of Sunitinib.

CONCLUSIONS: Sunitinib has a dose-dependent effect on QT interval. The increased risk of ventricular arrhythmias must be weighed against the therapeutic benefit sunitinib provides to patients with advanced cancer. (Clin Cancer Res 2009;15(22):7045-52). PMID: 19903787 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

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  Newer Fluoroquinolones May Improve Outcome in Extensively Drug-Resistant TB

Later-generation fluoroquinolones, such as levofloxacin, moxifloxacin, and sparfloxacin, show efficacy in the treatment of extensively drug-resistant tuberculosis (TB).Later-generation fluoroquinolones, such as levofloxacin, moxifloxacin, and sparfloxacin, show efficacy in the treatment of extensively drug-resistant tuberculosis (TB). Medscape Medical News (Source: Medscape Pulmonary Medicine Headlines)

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  Moxifloxacin effective for PPM eradication in COPD patients

Treatment with the antibiotic moxifloxacin is effective at eradicating potentially pathogenic microorganisms in the airways of patients with chronic obstructive pulmonary disease, but does not prevent recolonization, research shows. (Source: MedWire News - Respiratory)

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  A severely symptomatic case of anaerobic chronic bacterial prostatitis successfully resolved with moxifloxacin therapy.

Authors: Magri V, Restelli A, Marras E, Perletti G It has been demonstrated that patients showing symptoms of chronic bacterial prostatitis but culture-negative prostate-specific specimens can benefit from administration of antibacterial agents. This suggests that organisms that are not isolated in the routine practice may be responsible for prostate infection in an undefined fraction of subjects. Anaerobic bacteria have been proposed to play a pathogenic role in CBP, on the basis of studies describing clinical remission after eradication of pathogens like Peptostreptococcus spp. or Bacterioides spp. from prostatic secretions of symptomatic patients, or the significant association between prostatic infection by anaerobes and the presence of inflammation markers in prostatic secretions....

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  Moxifloxacin-induced changes in T-wave morphology

In this study, we evaluate changes in T-wave morphology (MCS) and QTc induced by moxifloxacin, an industry benchmark for subtle repolarization effects. (Source: Journal of Electrocardiology)

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  Manual and automatic measurements of moxifloxacin-induced QT prolongation

Accurate measurement of QT intervals is of pivotal importance in cardiac safety trials. Thorough QT studies must be designed to detect an 8- to 12-millisecond ΔΔQTc prolongation in a positive control group treated with moxifloxacin. QT measurements are typically performed manually to maximize measurement accuracy. Automatic QT measurements are more cost-effective, but the ability of commercial algorithms to detect moxifloxacin-induced QTc prolongation should be investigated. (Source: Journal of Electrocardiology)

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  Synthesis and evaluation of (99m)Tc-moxifloxacin, a potential infection specific imaging agent.

Authors: Chattopadhyay S, Saha Das S, Chandra S, De K, Mishra M, Ranjan Sarkar B, Sinha S, Ganguly S To synthesize and evaluate a (99m)Tc labeled fluroquinolone, moxifloxacin as a potential bacteria specific infection imaging agent. A radiolabeling formulation including moxifloxacin, [Moxicip(TM) injection, Cipla] (4mg), sodium pertechnetate and stannous chloride (5mug) gave the best radiolabeling efficiency and moderately stable labeled (99m)Tc moxifloxacin. Quality control analysis was performed by ITLC. Rats and rabbit with infectious intramuscular lesions induced in either thigh with E. Colli were used for studying biodistribution and scintigraphic imaging of the labeled product. Imaging of an infected thigh of a rabbit was performed with a gamma-camera at various intervals. A good...

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  AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Physicians Total Care, Inc.]

Updated Date: Oct 23, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Uveitis-like syndrome and iris transillumination after the use of oral moxifloxacin

Authors: M Wefers Bettink-Remeijer, K Brouwers, L van Langenhove, P W T De Waard, T O Missotten, J P Martinez Ciriano & E Van Aken (Source: Eye)

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  Acute Granulomatous Acanthamoeba Encephalitis in an Immunocompetent Patient

Conclusions  This case report demonstrates successful treatment of usually lethal GAE in an immunocompetent patient with high dose meropenem, linezolid, moxifloxacin and fluconazole followed by a partially adapted antimicrobial combination therapy. Content Type Journal ArticleCategory Practical PearlDOI 10.1007/s12028-009-9291-zAuthors Peter Lackner, Innsbruck Medical University Department of Neurology 6020 Innsbruck, Anichstrasse 35 Austria EuropeRonny Beer, Innsbruck Medical University Department of Neurology 6020 Innsbruck, Anichstrasse 35 Austria EuropeGregor Broessner, Innsbruck Medical University Department of Neurology 6020 Innsbruck, Anichstrasse 35 Austria EuropeRaimund Helbok, Innsbruck Medical University Department of Neurology 6020 Innsbruck, Anichstrasse 35...

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  Efficacy of four different moxifloxacin-based triple therapies for first-line H. pylori treatment

Abstract: Moxifloxacin has been used in the first-line treatment of Helicobacter pylori infection. The optimal dosage and duration have not been assessed.Aim: To evaluate the effectiveness of moxifloxacin, amoxicillin and esomeprazole in four regimens, in previously untreated patients infected by H. pylori.Methods and patients: Patients were randomly assigned to: esomeprazole 20mg b.i.d., amoxicillin 1g b.i.d., and one of each of the four following dosages of moxifloxacin: moxifloxacin 400mg b.i.d. for 10 days (EAM800×10), moxifloxacin 400mg b.i.d. for 7 days (EAM800×7), moxifloxacin 400mg b.i.d. for 5 days (EAM800×5), moxifloxacin 400mg o.i.d. for 10 days (EAM400×10). Eradication was assessed by the Urea Breath Test (UBT) 2 months following the end of therapy.Results: Ninety-four, 102...

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  Abuse of Antibiotic Prophylaxis in Third Molar Surgeries

I read with interest the article by Limeres et al, “Patients' perception of recovery after third molar surgery following postoperative treatment with moxifloxacin versus amoxicillin and clavulanic acid: A randomized, double-blind, controlled study,” describing the effect of antibiotic prophylaxis on patients' quality of life after third molar surgeries. Although the authors arrived at some valuable conclusions, the study also has some major shortcomings. (Source: Journal of Oral and Maxillofacial Surgery)

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  AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Physicians Total Care, Inc.]

Updated Date: Oct 20, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Levofloxacin trumps moxifloxacin for CAP

(Source: PharmacoEconomics and Outcomes News)

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  Antituberculars/moxifloxacin: Atopic dermatitis (first report with moxifloxacin) in an elderly patient: case report

(Source: Reactions)

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  Absence of Effect of Telbivudine on Cardiac Repolarization: Results of a Thorough QT/QTc Study in Healthy Participants.

This study therefore met the criteria for a negative thorough QT study. Telbivudine had no adverse effect on cardiac repolarization in healthy participants, even at supratherapeutic exposure, suggesting a broad safety margin. PMID: 19833860 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Pharmacology)

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  Lack of Electrocardiographic Effect of Dexlansoprazole MR, a Novel Modified-Release Formulation of the Proton Pump Inhibitor Dexlansoprazole, in Healthy Participants.

Authors: Vakily M, Wu J, Atkinson SN The effect of the proton pump inhibitor dexlansoprazole, an enantiomer of lansoprazole, on QT intervals was assessed after oral administration of a modifiedrelease formulation of dexlansoprazole (dexlansoprazole MR). In this randomized, positivecomparator, placebocontrolled, 4period crossover study, 40 healthy participants received single doses of dexlansoprazole MR 90 mg, dexlansoprazole MR 300 mg, moxifloxacin 400 mg, and placebo separated by 5day washout intervals. Twentyfourhour electrocardiograms were obtained at baseline and during each dosing period. The number and percentage of participants experiencing an increase in QT interval from baseline to maximum postdose value were evaluated during each dosing regimen, and pharmacokinetic profiles o...

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  Tissue penetration of moxifloxacin into human gallbladder wall in patients with biliary tract infections

Conclusions The results show that moxifloxacin penetrates well into gallbladder tissue and is therefore a therapeutic option for biliary tract infection. The highest concentrations in serum and gallbladder tissue were measured shortly after the end of a 1 h infusion. As perioperative prophylaxis, moxifloxacin should therefore be administered 30–60 min before the first surgical incision. (Source: Journal of Antimicrobial Chemotherapy)

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  Flucloxacillin, still the empirical choice for putative Staphylococcus aureus infections in intensive care units in the Netherlands

Conclusions The empirical choice of flucloxacillin in the case of putative S. aureus infections in patients admitted to ICUs in the Netherlands is still justified. (Source: Journal of Antimicrobial Chemotherapy)

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  Moxifloxacin: QT interval prolongation and torsade de pointes in an elderly patient: case report

(Source: Reactions)

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  Metronidazole/moxifloxacin: Orthostatic hypotension, nausea, vomiting and recurrent C. difficile infection, treated with nitazoxanide and probiotics: case report

(Source: Reactions)

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  A randomized double-blind comparison of moxifloxacin and doxycycline/metronidazole/ciprofloxacin in the treatment of acute, uncomplicated pelvic inflammatory disease

This multicentre, double-blind study was undertaken to demonstrate non-inferiority of once-daily oral moxifloxacin compared with combination therapy in the management of acute, uncomplicated pelvic inflammatory disease (PID). Women aged ≥18 years with PID were randomized to receive moxifloxacin (400 mg once daily) for 14 days or comparator treatment (doxycycline [100 mg twice daily] plus metronidazole [400 mg three times daily] for 14 days, plus one single 500-mg ciprofloxacin dose). Of the 434 valid per protocol (PP) patients, the overall clinical success rates at 2–14 days post-therapy were 96.6% (moxifloxacin) and 98.0% (comparator); moxifloxacin was non-inferior to the comparator regimen both in the PP (95% confidence interval [CI]: –4.5, 1.6) and intent-to-treat (95% CI...

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  Antibacterial class is not obviously important in outpatient pneumonia: a meta-analysis

Source: DARE Area: Evidence > Disease Focused Reviews CRD Summary: This review assessed whether improved clinical and mortality outcomes are achieved for outpatient community acquired pneumonia treated with antibacterials with coverage against atypical organisms. The authors concluded that there was no evidence of superiority for any drug comparison. Given some methodological uncertainties identified in the review process, the extent to which this conclusion was reliable was unclear. [The included studies assessed the following oral therapies at differing doses: fluoroquinolones (moxifloxacin, sparfloxacin, levofloxacin, grepafloxacin, trovafloxacin); macrolides (clarithromycin, azithromycin, roxithromycin); cephalosporins (cefaclor, cefixime, ceftidoren, cefuroxime); and penicillin (am...

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  Emerging Prevalence of Microsporidial Keratitis in Singapore: Epidemiology, Clinical Features, and Management

Conclusions: This study identifies an increasing incidence of microsporidial keratitis in Singapore with a strong correlation with prior soil exposure. Diffuse endotheliitis and limbitis have not been described and resolves with topical steroid therapy. Topical fluoroquinolone monotherapy is a valid treatment option.Financial Disclosure(s): Proprietary or commercial disclosure maybe found after the references. (Source: Ophthalmology)

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  Diversity of moxifloxacin resistance during a nosocomial outbreak of a predominantly ribotype ARU 027 Clostridium difficile diarrhea.

Authors: Carman RJ, Genheimer CW, Rafii F, Park M, Hiltonsmith MF, Lyerly DM To characterize the extent and diversity of moxifloxacin resistance among Clostridium difficile isolates recovered during a predominantly Anaerobe Reference Unit (ARU) ribotype 027-associated nosocomial outbreak of antibiotic associated diarrhea we measured the susceptibility of 34 field isolates and 6 laboratory strains of C. difficile to moxifloxacin. We ribotyped the isolates as well as assaying them by PCR for the metabolic gene, gdh, and the virulence genes, tcdA, tcdB, tcdC, cdtA and cdtB. All the laboratory isolates, including the historical ARU 027 isolate Cd196, were susceptible to moxifloxacin (</= 2mug/mL). 13 field isolates were susceptible to</=2mug/mL. Five were resistant to from 4 to 12mug...

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  Effects of Subinhibitory Concentrations of Antibiotics on Colonization Factor Expression by Moxifloxacin-Susceptible and Moxifloxacin-Resistant Clostridium difficile Strains.

The objective of this study was to analyze expression of these genes in the same conditions in four NAP1/027 strains, one moxifloxacin-susceptible and three moxifloxacin-resistant strains. Two in vitro selected moxifloxacin-resistant mutants were also analyzed. Moxifloxacin resistance was associated to the Thr82-->Ile substitution in GyrA in all moxifloxacin-resistant strains but one. The expression of cwp84 and slpA was strongly increased after culture with ampicillin or clindamycin in NAP1/027 strains. Interestingly, after culture with fluoroquinolones, the expression of cwp84 and slpA was only increased in four moxifloxacin-resistant strains, including the NAP1/027 strains and one of the in vitro selected mutants. The cwp84 overexpression was correlated with an increased production o...

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  Bacterial strain-to-strain variation in the pharmacodynamic index magnitude: a hitherto unconsidered factor in establishing antibiotic clinical breakpoints.

Authors: Macgowan AP, Reynolds R, Noel AR, Bowker KE Antibiotic pharmacodynamic modelling allows variations in pathogen susceptibility and human pharmacokinetics to be accounted for when considering antibiotic doses, potential bacterial pathogen targets for therapy, and clinical susceptibility breakpoints. Variation in the pharmacodynamic index (AUC24/MIC, Cmax/MIC, T>MIC) is not usually considered. In an in vitro pharmacokinetic model of infection using a dose ranging design, we established the relationship between AUC24/MIC and antibacterial effect for moxifloxacin against 10 strains of S. aureus. The distributions of AUC24/MIC targets for a 24h static, 1-log, 2-log, and 3-log drop in bacterial counts were used to calculate potential clinical breakpoint values and these were compa...

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  Anti-inflammatory effects of antibacterials on human bronchial epithelial cells

Background: Human Bronchial epithelial cells (hu-BEC) have been claimed to play a significant role in the pathogenesis of chronic inflammatory airway diseases like COPD. In this context IL-8 and GM-CSF have been shown to be key cytokines. Some antibiotics which are routinely used to treat lower respiratory tract infections have been shown to exert additional immunomodulatory or anti-inflammatory effects. We investigated whether these effects can also be detected in hu-BEC. Methods: Hu-BEC obtained from patients undergoing lung resections were transferred to air-liquid-interface (ALI) culture. These cultures were incubated with cefuroxime (CXM, 10-62.5 mg/l), azithromycin (AZM, 0.1-1.5 mg/l), levofloxacin (LVX, 1-8 mg/l) and moxifloxacin (MXF, 1-16 mg/l). The spontaneous and TNF-alpha (10 n...

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  One-day application of topical moxifloxacin 0.5% to select for fluoroquinolone-resistant coagulase-negative Staphylococcus

Purpose: To compare selection for fluoroquinolone-resistant bacteria between 1-day and 3-day application of topical moxifloxacin 0.5%.Setting: Department of Ophthalmology, Stanford University, Stanford, California, USA.Methods: After investigative review board approval, patients scheduled for ocular surgery were randomized to receive topical moxifloxacin 0.5% drops 4 times a day for 1 day or 3 days preoperatively. Conjunctival cultures were obtained at baseline and after antibiotic application. Bacteria were identified and tested for resistance to a battery of antibiotic agents using the Kirby-Bauer disk-diffusion method. The differences in resistance distributions for the most commonly isolated bacteria between baseline (T0) and after antibiotic administration (T1) were compared between t...

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  Should moxifloxacin be substituted for isoniazid as a first-line antituberculosis drug?

Authors: Mohapatra PR PMID: 19762595 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)

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  Efficacy and Safety of Sequential Intravenous/Oral Moxifloxacin vs Intravenous/Oral Amoxicillin/Clavulanate for Complicated Skin and Skin Structure Infections

Conclusions  Treatment with sequential iv/po moxifloxacin monotherapy once daily is clinically comparable to that with iv/po amoxicillin/clavulanate three times daily in the management of cSSSIs. Moxifloxacin’s simple dose regimen offers an advantage over amoxicillin/clavulanate and represents a valuable addition to current antibiotic regimens used in the treatment of cSSSIs. Content Type Journal ArticleCategory Clinical and Epidemiological StudyDOI 10.1007/s15010-009-8468-xAuthors R. Vick-Fragoso, Hospital General “Dr Manuel Gea González” Infectious Disease Dept. Calzada de Tlalpan Tlalpan, Mexico, D.F. MexicoG. Hernández-Oliva, Centro Médico Nacional “La Raza”/Bayer de México Hospital de Infectología Mexico City MexicoJ. Cruz-Alcázar, Centro Médico N...

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  In vitro activities of moxifloxacin and tigecycline against bacterial isolates associated with intraabdominal infections at a medical center in Taiwan, 2001–2006

This study found that moxifloxacin and tigecycline exhibited good in vitro activity against bacterial isolates causing IAIs. Content Type Journal ArticleCategory ArticleDOI 10.1007/s10096-009-0801-xAuthors C.-Y. Liu, National Taiwan University College of Medicine Department of Internal Medicine, National Taiwan University Hospital Taipei TaiwanC.-L. Lu, National Taiwan University College of Medicine Department of Internal Medicine, National Taiwan University Hospital Taipei TaiwanY.-T. Huang, National Taiwan University College of Medicine Department of Laboratory Medicine, National Taiwan University Hospital Taipei TaiwanC.-H. Liao, Far Eastern Memorial Hospital Department of Internal Medicine Taipei County TaiwanP.-R. Hsueh, National Taiwan University College of Medicine Department ...

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  [Intracameral moxifloxacin: a safe option for endophthalmitis prophylaxis? : In vitro safety profile for intraocular application.]

CONCLUSION: Vigamox(R) did not show significant toxicity on primary RPEs, TMCs, LECs, CECs, or human corneal endothelium at concentrations up to 150 microg/ml. The MIC90 of moxifloxacin for pathogens commonly encountered in endophthalmitis is known to be in the range of 0.25-2.5 microg/ml. Therefore, intracameral use of Vigamox(R) at concentrations up to 150 microg/ml may be safe and effective for preventing endophthalmitis after intraocular surgery. PMID: 19756636 [PubMed - as supplied by publisher] (Source: Der Ophthalmologe)

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  Subinhibitory concentrations of moxifloxacin decrease adhesion and biofilm formation of Stenotrophomonas maltophilia from cystic fibrosis.

Authors: Pompilio A, Catavitello C, Picciani C, Confalone P, Piccolomini R, Savini V, Fiscarelli E, D'Antonio D, Di Bonaventura G Stenotrophomonas maltophilia is an emerging nosocomial bacterial pathogen which is currently isolated with increasing frequency from the airways of cystic fibrosis (CF) patients. We evaluated the effect of subinhibitory concentrations of moxifloxacin against adhesion, biofilm formation, and cell-surface hydrophobicity of two strains of Stenotrophomonas maltophilia isolated from CF patients. Adhesion and biofilm formation assays were carried out on polystyrene and quantified by colony counts. CSH was determined by adhesion to n-hexadecane test. Moxifloxacin at 0.03x and 0.06xMIC caused a significant decrease of adhesion and biofilm formation by both strains t...

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  Moxifloxacin-Containing Triple Therapy as Second-Line Treatment for Helicobacter pylori Infection: Effect of Treatment Duration and Antibiotic Resistance on the Eradication Rate

Conclusion: The 7-day moxifloxacin-containing triple therapy produced an unacceptably low eradication rate. Increasing the duration of therapy was expected to increase the eradication rate, but the expected increased did not materialize, most likely because of coincident marked increase in the prevalence of resistance to moxifloxacin. Tailored treatment based on antibiotic susceptibility testing might be more effective in the achievement of high eradication rate when rapid antibiotic resistance such as moxifloxacin is occurring. (Source: Helicobacter)

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  Antimicrobial susceptibilities of Mycoplasma genitalium by broth dilution and quantitative PCR.

Authors: Hamasuna R, Jensen JS, Osada Y Only limited information regarding the antimicrobial susceptibilities of Mycoplasma genitalium is available because of difficulties in isolating M. genitalium strains from clinical specimens. Antimicrobial susceptibilities of 15 clinical isolates, 7 ATCC strains and an early-passage of the M30 strain were examined by the broth-dilution method. Azithromycin, clarithromycin, sitafloxacin and moxifloxacin were the most active drugs to M. genitalium and their MIC90 values were 0.002, 0,008, 0.125 and 0.125 mg/liter, respectively. PMID: 19738019 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  In vitro Activity of Nemonoxacin, a Novel Non-fluorinated Quinolone, against 2,440 Clinical Isolates.

Authors: Adam HJ, Laing NM, King CR, Lulashnyk B, Hoban DJ, Zhanel GG The in vitro activity of nemonoxacin, a novel non-fluorinated quinolone, was tested against 2,440 clinical isolates. Nemonoxacin was at least 4 fold more active than levofloxacin and moxifloxacin against most Gram-positive cocci tested [MIC90/range (microg/ml): community-associated methicillin-resistant Staphylococcus aureus, 0.5/0.015-2; Staphylococcus epidermidis, 0.5/0.015-4 (methicillin-susceptible), 2/0.12-2 (methicillin-resistant); Streptococcus pneumoniae, 0.015/</=0.008-0.25; Enterococcus faecalis, 1/0.03-128]. Activity against Gram-negative bacilli was similar to levofloxacin and moxifloxacin [MIC90/range (microg/ml): Escherichia coli, 32/</=0.015->/=512; Klebsiella pneumoniae, 2/</=0.015-128; K....

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  Absence of QTc Prolongation in a Thorough QT Study With Subcutaneous Liraglutide, a Once-Daily Human GLP-1 Analog for Treatment of Type 2 Diabetes.

The objective of this study was to establish effects of liraglutide on the QTc interval. In this randomized, placebo-controlled, double-blind crossover study, 51 healthy participants were administered placebo, 0.6, 1.2, and 1.8 mg liraglutide once daily for 7 days each. Electrocardiograms were recorded periodically over 24 hours at the end of placebo and highest dosing periods. Four different models for QT correction were used: QTci, as the primary endpoint, and QTciL, QTcF, and QTcB as secondary endpoints. The upper bound of the 1-sided 95% confidence interval for time-matched, baseline-corrected, placebo-subtracted QTc intervals was <10 ms for all 4 correction methods. Moxifloxacin (400 mg) increased QTc intervals by 10.6 toms at 2 hours. There was no concentration-exposure dependency...

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  In vitro susceptibility to 17 antimicrobials of clinical Clostridium difficile isolates collected in 1993–2007 in Sweden

This study investigated the MICs of 17 antimicrobials, for 606 toxigenic clinical isolates of Clostridium difficile collected between 1993 and 2007 in Sweden. Low MIC90 values were found for metronidazole (0.5 mg/L), vancomycin (1.0 mg/L), teicoplanin (0.125 mg/L), fusidic acid (1.0 mg/L), linezolid (2.0 mg/L), daptomycin (2.0 mg/L) and tigecycline (0.064 mg/L). Three isolates (0.5%) had elevated MICs for vancomycin (4[ndash]8 mg/L); however, these isolates originated from the same patient, who was receiving long-term intravenous vancomycin treatment. High-level clindamycin resistant isolates (MIC >256 mg/L) peaked in 1997 with 39 of 95 (41%) and out of these, 36% were also highly resistant to erythromycin. [beta]-Lactams such as penicillin V and piperacillin displayed MIC90s of 8 and 32 m...

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  Pharmacokinetics of Moxifloxacin in Cerebrospinal Fluid and Plasma in Patients with Tuberculous Meningitis

Clinical Infectious Diseases, Volume 0, Issue 0, Page 000, Latest Articles. Moxifloxacin cerebrospinal fluid (CSF) penetration was evaluated by obtaining full plasma and CSF time concentration curves for 4 patients with tuberculous meningitis. The geometric mean ratio of the areas under the curve for CSF to plasma were 0.82 (range, 0.70–0.94) at 400 mg once per day and 0.71 (0.58–0.84) at 800 mg once per day. (Source: Clinical Infectious Diseases Latest Issue)

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  Dexrazoxane protects the heart from acute doxorubicin-induced QT prolongation: a key role for IKs

Conclusion and implications: Doxorubicin acutely prolonged the QT interval in guinea-pig heart by selective IKs blockade. This effect was prevented by dexrazoxane. This result is important because it illustrates the danger of neglecting IKs in favour of hERG screening alone, for early preclinical testing for possible induction of torsade de pointes. (Source: British Journal of Pharmacology)

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  Comparative Analysis of Length of Stay, Total Costs, and Treatment Success between Intravenous Moxifloxacin 400 mg and Levofloxacin 750 mg among Hospitalized Patients with Community-Acquired Pneumonia

Conclusions: In-hospital treatment of CAP with IV moxifloxacin 400 mg or IV levofloxacin 750 mg was associated with similar hospital LOS and costs in propensity-matched cohorts. (Source: Value in Health)

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  AVELOX (Moxifloxacin Hydrochloride) Injection, Solution AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Schering Plough Corporation]

Updated Date: Aug 19, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Abstract: Management of community-origin complicated intra-abdominal infections (cIAIs) requires surgical intervention and antimicrobial therapy. This multinational, randomised, double-blind clinical trial carried out in Asia compared the efficacy and safety of moxifloxacin monotherapy and ceftriaxone/metronidazole combination therapy in adults with confirmed or suspected cIAI. Patients received surgical intervention and either intravenous (i.v.) moxifloxacin 400mg once daily or i.v. ceftriaxone 2g once daily plus i.v. metronidazole 500mg twice daily. A total of 364 patients were randomised [intent-to-treat (ITT), moxifloxacin N=180, comparator N=181; per-protocol (PP), moxifloxacin N=174, comparator N=171]. The most common cIAI diagnosis was complicated appendicitis. Moxifloxacin was non-...

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  Kill rates of preserved and preservative-free topical 8-methoxy fluoroquinolones against various strains of Staphylococcus

Purpose: To assess the kill rates of preserved and preservative-free 8-methoxy fluoroquinolones and benzalkonium chloride (BAC) against isolates of Staphylococcus aureus and coagulase-negative Staphylococcus (CNS) species.Setting: Bascom Palmer Eye Institute, Miami, Florida, USA.Methods: Ocular and standard isolates of S aureus and CNS were inoculated with saline, 0.005% BAC, gatifloxacin 0.3% containing 0.005% BAC (Zymar), or BAC-free moxifloxacin 0.5% (Vigamox) at 37°C. Bacterial viability was assessed after 15 minutes, 30 minutes, and 60 minutes.Results: Thirteen isolates of S aureus and 5 isolates of CNS were used. The mean initial load of bacterial inoculum was 5.45 log colony-forming units (CFU)/mL ± 0.37 (SD). Saline did not affect the density of staphylococci; BAC significantly d...

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  Aqueous humor penetration of fourth-generation fluoroquinolone ophthalmic solutions given by multiple administration in a rabbit model

Abstract  We investigated the aqueous humor concentration of topically applied gatifloxacin (GFLX) 0.3% and moxifloxacin (MFLX) 0.5% in a rabbit model of surgical and nonsurgical eyes. Topical administration in eyes was performed eight times, at 15-min intervals. Surgical eyes had undergone cataract surgery with the implantation of an intraocular lens (IOL). Aqueous humor was sampled at 5, 30, and 120 min after drug administration. Drug concentrations were determined by high-performance liquid chromatography (HPLC). The GFLX concentrations in surgical eyes at 5, 30, and 120 min post-administration were 12.1, 14.0, and 6.1 g/ml, and those in nonsurgical eyes were 11.3, 11.5, and 7.1 g/ml; there were no differences between surgical and nonsurgical eyes. The concentrations of ...

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  Fluoroquinolone resistance in Mycobacterium tuberculosis and mutations in gyrA and gyrB.

This study evaluated cross-resistance among ofloxacin, moxifloxacin and gatifloxacin and investigated the presence of mutations in gyrA and gyrB. Fluoroquinolone susceptibility was determined in 41 M. tuberculosis strains by the proportion method on 7H11 and minimal inhibitory concentrations were determined by the resazurin microtiter assay. Forty strains shared the same resistance results for the three fluoroquinolones. However, one strain with mutation at Asn-533-->Thr in gyrB was susceptible to ofloxacin but resistant to moxifloxacin and gatifloxacin. PMID: 19687244 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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  Impact of spore biology on the rate of kill and suppression of resistance in Bacillus anthracis.

Authors: Drusano GL, Okusanya OO, Okusanya AO, van Scoy B, Brown DL, Fregeau C, Kulawy R, Kinzig M, Sörgel F, Heine HS, Louie A Bacillus anthracis is complex because of its spore form. The spore is invulnerable to antibiotic action. It also has an impact on the resistance emergence. We employed the hollow fiber infection model to study the impact of different doses and schedules of moxifloxacin on the total organism population, the spore population and the subpopulations of vegetative- and spore-phase organisms that were resistant to moxifloxacin. We then generated a mathematical model of the impact of moxifloxacin on vegetative- and spore-phase organisms when administered by continuous-infusion or daily-administration. The ratio of rate constants for vegetative-to-spore phase (Kv...

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  Efficacy of moxifloxacin or gatifloxacin as prophylaxis against experimental murine Brucella melitensis infection

Abstract: The prophylactic potential of moxifloxacin and gatifloxacin was assessed in comparison with doxycycline, an established therapeutic antibiotic, to limit or control infection by Brucella melitensis in an experimental mouse model, determined by reduced bacterial burden in the spleen. Although moxifloxacin was found to have a small protective effect when administered 6h following infection, neither moxifloxacin nor gatifloxacin showed significant efficacy in vivo. In comparison, doxycycline provided significant protection when prophylaxis was started at 6h, 7 days or 14 days following infection. Overall, these results confirm the utility of doxycycline in the prophylaxis of brucellosis and suggest that neither moxifloxacin nor gatifloxacin are likely to be valuable for post-exposure...

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  Susceptibility and bactericidal activity of 8 oral quinolones against conventional-fluoroquinolone-resistant Streptococcus pneumoniae clinical isolates

Abstract: We evaluated the pharmacokinetic/pharmacodynamic parameters of 8 oral quinolones (ciprofloxacin, garenoxacin [GRNX], gatifloxacin, levofloxacin, moxifloxacin, prulifloxacin, sitafloxacin, and sparfloxacin) on 11 fluoroquinolone-resistant Streptococcus pneumoniae strains, screened from 780 strains isolated from various clinical sources in Japan. GRNX showed the highest area under the blood concentration time curve/MIC ratios, which exceeded the target values for bacterial eradication against all fluoroquinolone-resistant S. pneumoniae strains. (Source: Diagnostic Microbiology and Infectious Disease)

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  Pharmacodynamics of moxifloxacin against a high inoculum of Escherichia coli in an in vitro infection model

Conclusions Our results suggest that suboptimal dosing may facilitate resistance amplification in a high inoculum of E. coli. The clinical dose of moxifloxacin (400 mg/day) was adequate to suppress resistance development in three wild-type strains. Clinical relevance of these findings warrants further in vivo investigation. (Source: Journal of Antimicrobial Chemotherapy)

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  Cutaneous miliary resistant tuberculosis in a patient infected with human immunodeficiency virus: case report and literature review

We report the case of a patient infected with human immunodeficiency virus who presented with fever and a disseminated papulous eruption, diagnosed as cutaneous miliary tuberculosis. The diagnosis was made by histological examination of a skin biopsy, which showed numerous acid-fast bacilli. A culture grown from a skin biopsy isolated a resistant Mycobacterium tuberculosis strain. The papules disappeared within a few days after starting treatment with pyrazinamide, isoniazid and moxifloxacin. (Source: Clinical And Experimental Dermatology)

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  Efficacy and Safety of Besifloxacin Ophthalmic Suspension 0.6% Compared with Moxifloxacin Ophthalmic Solution 0.5% for Treating Bacterial Conjunctivitis

Conclusions: Besifloxacin ophthalmic suspension was non inferior to moxifloxacin ophthalmic suspension and provided similar safety and efficacy (clinical and microbiological) outcomes when used for the treatment of bacterial conjunctivitis.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. (Source: Ophthalmology)

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  Outbreak of Clostridium difficile 027 infection in Vienna, Austria 2008-2009.

Authors: Indra A, Huhulescu S, Fiedler A, Kernbichler S, Blaschitz M, Allerberger F From November 2008 to 15 April 2009, 36 isolates of CD027 identified in Austria, all originating from four hospitals in Vienna. All isolates were positive for toxin A, toxin B and the binary toxin, and showed a characteristic 18 bp deletion in the tcdC gene. Clostridium difficile is an anaerobic spore-forming bacterium. Some strains may cause diarrhoea due to formation of toxins. Symptomatic C. difficile infection (CDI) is primarily linked with hospital admission and antibiotic treatment, although antibiotic exposure is neither necessary nor sufficient for CDI [1,2]. In Belgium, for instance, one third of CDI cases reported in the hospital surveillance system are not hospital-associated [3]. Symptoms ra...

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  In vitro activities of the newly synthesised ER-2 against clinical isolates of Mycobacterium tuberculosis susceptible or resistant to antituberculosis drugs

Abstract: Two hundred isolates of Mycobacterium tuberculosis were evaluated for their susceptibility to a newly synthesised quinolone derivative, ER-2, compared with ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin. ER-2 and moxifloxacin showed the greatest activity [MIC for 90% of strains tested (MIC90)=0.5μg/mL], although levofloxacin and ciprofloxacin showed good activity with an MIC90 of 1μg/mL. More importantly, ER-2 showed excellent activity against M. tuberculosis H37Rv both in the lungs and spleen of mice, indicating the potential therapeutic value of ER-2 against M. tuberculosis. (Source: International Journal of Antimicrobial Agents)

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  Lack of effect of aprepitant or its prodrug fosaprepitant on QTc intervals in healthy subjects.

CONCLUSIONS: In subjects receiving fosaprepitant 200 mg, no clinically meaningful increases in QTc were seen at any timepoint, whereas after moxifloxacin 400 mg, increases were observed at the approximate T(max) of moxifloxacin and additional timepoints. The lack of QTc increase at this high dose of fosaprepitant and resulting aprepitant plasma exposures support the expectation that clinical doses of fosaprepitant or aprepitant will not be associated with significant QTc prolongation. PMID: 19608812 [PubMed - in process] (Source: Anesthesia and Analgesia)

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  Moxifloxacin induced fatal hepatotoxicity in a 72-year-old man: a case report

We describe a case of fatal hepatotoxicity caused by Moxifloxacin in a 72-year-old man. He presented with jaundice and epigastric tenderness that started one week after being treated for acute exacerbation of his chronic bronchitis with Moxifloxacin by his primary care physician. He was admitted to intensive care unit for close monitoring. His labs showed marked elevation in liver enzymes and bilirubin. His condition continued to deteriorate in intensive care unit despite supportive care. Acute hepatic failure which resulted in his death was attributed to idiosyncratic reaction to Moxifloxacin. (Source: Cases Journal)

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  A Thorough QTc Study to Assess the Effect of Sitagliptin, a DPP4 Inhibitor, on Ventricular Repolarization in Healthy Subjects.

In conclusion, at clinically relevant concentrations, sitagliptin is not associated with clinically meaningful QTcf prolongation. PMID: 19602719 [PubMed - in process] (Source: The Journal of Clinical Pharmacology)

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  Moxifloxacin: Hyponatraemia (first report) in an elderly patient: case report

(Source: Reactions)

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  C. pneumoniae community-acquired pneumonia (CAP) in mimicking Mycoplasma pneumoniae meningoencephalitis complicated by asthma

We present the case of a young man who presented with M. pneumoniae-like illness and was hospitalized for severe CAP that was accompanied by a pertussis-like cough and severe headache. Although his chest x-ray showed a right upper lobe infiltrate, a lumbar puncture was performed to rule out meningitis, but his cerebrospinal fluid profile was unremarkable. Titers for non-zoonotic atypical pneumonia pathogens were negative except for a highly elevated C. pneumoniae immunoglobulin-M titer (1:320). Testing for legionella and pertussis was negative. Q fever and adenoviral titers were also negative. Cold agglutinin titers were repeatedly negative. The patient was successfully treated with moxifloxacin but developed permanent asthma after C. pneumoniae CAP. This case is unusual in several aspects...

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  In vivo characterization of the peptide deformylase inhibitor LBM415 in murine infection models.

In this study, the in vivo efficacy of LBM415 was evaluated in various mouse infection models. We investigated activity against a systemic infection model caused by intraperitoneal inoculation of S. aureus (methicillin susceptible, MSSA, and resistant, MRSA) and S. pneumoniae (penicillin susceptible, PSSP, and multidrug resistant, MDRSP), a thigh infection model caused by intramuscular injection of MRSA, and a lung infection produced by intranasal inoculation of PSSP. In the systemic MSSA and MRSA infection, LBM415 was equivalent to linezolid and vancomycin. In the systemic PSSP infection, LBM415 was equivalent to linezolid, whereas against systemic MDRSP infection, the LBM415 ED50 was 4.8 mg/kg (dosed subcutaneously) and 36.6 mg/kg (dosed orally), as compared to 13.2 mg/kg for telithromyc...

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  Moxifloxacin: Hyponatraemia (first report) in an elderly patient: case report.

Page: 24 (Source: Reactions Weekly)

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  Mutational paths towards increased fluoroquinolone resistance in Legionella pneumophila

Conclusions Specific mutational trajectories were identified, strongly suggesting that intermolecular epistatic interactions between DNA topoisomerases underlie the mechanism of fluoroquinolone resistance in L. pneumophila. Our results suggest that L. pneumophila has strong potential to become resistant to fluoroquinolone compounds and warrant further investigation of resistance in clinical and environmental strains of this pathogen. (Source: Journal of Antimicrobial Chemotherapy)

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  Evaluation of the mutant selection window for fluoroquinolones against Neisseria gonorrhoeae

Conclusions Evaluation of the use of moxifloxacin against N. gonorrhoeae is warranted, as is use of multiple-dose fluoroquinolone regimens. (Source: Journal of Antimicrobial Chemotherapy)

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  Avelox

Drug/Device: Avelox Defendant(s): Bayer Corp. Case name: Carol Simjian v. Bayer Corp., No. 09-947 Full story on lexis.com (Source: LexisNexis® Mealey's™ Emerging Drugs & Devices Legal News)

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  Over the Counter Availability of Antituberculosis Drugs in Tbilisi, Georgia in the Setting of a High Prevalence of MDR-TB

Georgia, a country of 4.5 million people, has a high incidence of tuberculosis (TB) including drug resistant cases. Easy access and inappropriate use of anti-TB drugs are risk factors for further development of multidrug resistant (MDR)-TB. We carried out an investigation to assess the availability of over the counter anti-TB agents in pharmacies in Tbilisi. During February 2006, 15 pharmacies were randomly selected and the pharmacist at each store was interviewed. We found that all anti-TB medications stocked by these pharmacies were available and sold without a prescription. All 15 pharmacies sold isoniazid, rifampicin, and streptomycin; 13 (87%) of 15 pharmacies also sold pyrazinamide, ethambutol. Second line anti-TB drugs such as amikacin and kanamycin (injectable agents) and olde...

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  Acyclovir-induced renal failure in an obese patient.

CONCLUSION: An obese man receiving excessive doses of i.v. acyclovir developed acute but reversible renal failure. PMID: 19574603 [PubMed - as supplied by publisher] (Source: American Journal of Health-System Pharmacy : AJHP)

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  AVELOX (Moxifloxacin Hydrochloride) Injection, Solution AVELOX (Moxifloxacin Hydrochloride) Tablet, Film Coated [Bayer HealthCare Pharmaceuticals Inc]

Updated Date: Jun 30, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Cost-Effectiveness Analysis of Intracameral Cefuroxime Use for Prophylaxis of Endophthalmitis after Cataract Surgery

Conclusions: Administration of intracameral cefuroxime is relatively cost-effective in preventing endophthalmitis after cataract surgery. Owing to their high costs, many commonly used topical antibiotics are not cost-effective compared with intracameral cefuroxime, even under optimistic assumptions about their efficacy.Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. (Source: Ophthalmology)

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  Efficacy of Fluoroquinolones against Pathogenic Oral Bacteria.

This article reviews the characteristics of the main fluoroquinolones used in dentistry (ciprofloxacin, levofloxacin and moxifloxacin), including pharmacokinetic/ pharmacodynamic parameters, susceptibility profiles of oral bacteria and clinical trials on their efficacy in dental practice. It seems that some of these antibiotics might represent a safe alternative in patients with allergy, intolerance, or lack of response to beta-lactams. PMID: 19534690 [PubMed - as supplied by publisher] (Source: Mini Reviews in Medicinal Chemistry)

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  [Correspondence] Moxifloxacin versus ethambutol in initial tuberculosis treatment

Marcus Conde and co-workers (April 4, p 1183) show, in a randomised, controlled phase II trial, that moxifloxacin substituted for ethambutol significantly improves the 8-week culture status in patients with newly diagnosed tuberculosis. This finding agrees with that of the OFLOTUB study, but differs from that of the Tuberculosis Consortium Study 27. Closer examination of the findings by Conde and colleagues raises some concerns that might require clarification. (Source: LANCET)

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  [Correspondence] Moxifloxacin versus ethambutol in initial tuberculosis treatment

Marcus Conde and colleagues conclude that moxifloxacin improves culture conversion in the initial phase of treatment in adults with sputum-smear-positive tuberculosis. We agree with these data but would like to add some comments. (Source: LANCET)

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  [Correspondence] Moxifloxacin versus ethambutol in initial tuberculosis treatment – Authors' reply

Kwok Chiu Chang and Chi Chiu Leung question the lack of an association between the number of acid-fast bacilli (AFB) per high-power field (HPF) on sputum microscopy and the presence of cavitation on chest radiograph, and wonder whether differences in smear results at baseline might explain the better outcome with moxifloxacin. (Source: LANCET)

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  Comparison of Semiautomated and Fully Automated Methods for QT Measurement During a Thorough QT/QTc Study: Variability and Sample Size Considerations.

This study compares the ability of 2 semiautomated methods with a fully automated method for QT measurement to minimize the sample size required to detect a moxifloxacin effect and exclude a placebo effect in a thorough QT/QTc study. The fully automated and 1 of 2 semiautomated methods used a global QT measurement in 12 leads, whereas the other semiautomated method used a tangent method on single lead raw complexes. Mean QTcF intervals were greater when measured on a global QT electrocardiogram than on raw complexes, but the mean magnitudes of DeltaQTcF were similar for all methods. The 3 methods detected a statistically significant increase in QTcF for moxifloxacin compared to placebo and were able to exclude a placebo effect on QTcF in all 62 participants. However, due to a smaller varia...

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  Over the Counter Availability of Antituberculosis Drugs in Tbilisi, Georgia in the Setting of a High Prevalence of MDR-TB

Georgia, a country of 4.5 million people, has a high incidence of tuberculosis (TB) including drug resistant cases. Easy access and inappropriate use of anti-TB drugs are risk factors for further development of multidrug resistant (MDR)-TB. We carried out an investigation to assess the availability of over the counter anti-TB agents in pharmacies in Tbilisi. During February 2006, 15 pharmacies were randomly selected and the pharmacist at each store was interviewed. We found that all anti-TB medications stocked by these pharmacies were available and sold without a prescription. All 15 pharmacies sold isoniazid, rifampicin, and streptomycin; 13 (87%) of 15 pharmacies also sold pyrazinamide, ethambutol. Second line anti-TB drugs such as amikacin and kanamycin (injectable agents) and olde...

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  Addition of PNU-100480 to First-line Drugs Shortens the Time Needed to Cure Murine Tuberculosis.

CONCLUSIONS: Together with previous findings, these results confirm that PNU-100480, which is now in Phase I clinical testing, has sterilizing activity in the murine model and suggest that it may be capable of shortening treatment duration for drug-susceptible as well as drug-resistant tuberculosis in humans. PMID: 19520903 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

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  Moxifloxacin: Acute generalised exanthematous pustulosis (first report) in an elderly patient: case report

(Source: Reactions)

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  Comparative in vitro activities of nemonoxacin, doripenem, tigecycline and 16 other antimicrobials against Nocardia brasiliensis, Nocardia asteroides and unusual Nocardia species

Conclusions The results of this in vitro study suggest that nemonoxacin, linezolid and tigecycline show promise as treatment options for nocardiosis. Further investigation of their clinical role is warranted. (Source: Journal of Antimicrobial Chemotherapy)

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  Disseminated systemic Nocardia farcinica infection complicating alefacept and infliximab therapy in a patient with severe psoriasis

Summary: Nocardiosis is a cause of significant morbidity and mortality in the immunocompromised host, and is an infrequent complication of tumor necrosis factor alpha (TNF-α) blockers in chronic inflammatory diseases. Nocardiosis occurs at a rate of 3.55 and 0.88 per 100 000 patients treated with infliximab or etanercept, respectively. Disseminated nocardiosis remains an uncommon complication of these agents. Here, we present a fatal case of disseminated systemic nocardiosis in a patient with psoriasis following sequential therapy with alefacept and then infliximab therapy. The patient developed disseminated disease involving the brain, lymph nodes, and adrenal glands. The diagnosis was made by blood culture and aspiration of the adrenal gland abscess, which revealed Gram-positive bacilli...

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  Moxifloxacin: Acute generalised exanthematous pustulosis (first report) in an elderly patient: case report.

Page: 25 (Source: Reactions Weekly)

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  Prospective Randomized Comparison of 1-Day and 3-Day Application of Topical 0.5% Moxifloxacin in Eliminating Preoperative Conjunctival Bacteria

Journal of Ocular Pharmacology and Therapeutics , Vol. 0, No. 0. (Source: Journal of Ocular Pharmacology and Therapeutics)

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  Increasing In vitro Resistance to Moxifloxacin and Gatifloxacin Among S. epidermidis Isolates Recovered from Patients with Endophthalmitis Following Cataract Surger

Darlene Miller, DHSC, MPH, SM, CIC, Assistant Research Professor; Eduardo C. Alfonso, MD, Professor, Bascom Palmer Eye Inst, Miami, FL Issue: Increasing resistance to fluoroquinolones among Staphylococcus epidermidis isolates recovered from patients with Endophthalmitis have important implications for the prevention and treatment of these post surgical infections and the preservation of vision. (Source: American Journal of Infection Control)

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  Evidence for Practice

Prophylactic regimens for endophthalmitis after cataract surgery include topical antibiotic drops and local antisepsis. However, there is increasing attention on the value of intracameral injection of antibiotics at the close of cataract surgery because this provides immediate, high, sustained antibiotic levels. Cefuroxime has been documented to be safe and effective when used via the intracameral route, and research continues on other antibiotic agents that may prove safe for intracameral injection as alternatives to address ongoing shifts in antimicrobial spectra and sensitivities. Fourth generation fluoroquinolones have been used in topical preoperative and postoperative antibiotic regimens for cataract surgery because of their broad spectrum of activity and overall safety. These agents...

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  Electrocardiographic QTc Changes Due to Moxifloxacin Infusion.

Authors: Malik M, Hnatkova K, Schmidt A, Smetana P Moxifloxacin (400-mg single dose) is a frequent positive control in thorough QT/QTc studies. This investigation assessed baseline and placebo-controlled QTc changes (DeltaDeltaQTc, individualized correction for heart rate and rate hysteresis) at 126 data points before, during, and after 1-hour moxifloxacin infusion in 44 healthy participants and in their sex-, race-, and age-defined subgroups. Constant linear DeltaDeltaQTc increase was found during the infusion. The postinfusion peak DeltaDeltaQTc values (corresponding to maximum plasma levels) were not statistically different in women (16.1 +/- 6.5 ms) and men (15.1 +/- 5.3 ms), Africans (15.3 +/- 5.3 ms) and whites (15.6 +/- 6.6 ms), and participants younger (16.5 +/- 4.8 ms) and old...

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  Pharmacokinetic, pharmacodynamic, and electrocardiographic effects of dapoxetine and moxifloxacin compared with placebo in healthy adult male subjects.

Authors: Modi NB, Nath R, Staehr P, Gupta SK, Aquilina JW, Rivas D Selective serotonin reuptake inhibitors (SSRIs) may be associated with electrocardiographic effects. The electrocardiographic pharmacodynamics of dapoxetine, a short-acting SSRI being developed for the treatment of premature ejaculation, are compared with those of placebo and moxifloxacin (positive control) in 2 single-center, randomized, crossover studies in healthy men. In study 1, subjects receive 2 doses of dapoxetine 120 mg, given 3 hours apart; a single dose of moxifloxacin 400 mg; and 2 doses of placebo, given 3 hours apart. In study 2, subjects receive single doses of dapoxetine 60 mg, dapoxetine 120 mg, moxifloxacin 400 mg, and placebo. Moxifloxacin significantly increases QT and corrects QT intervals (QTc) com...

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