Medical uses
Moxifloxacin treats a number of infections, including respiratory-tract infections, bubonic plague, cellulitis, anthrax, intra-abdominal infections, endocarditis, meningitis, and tuberculosis.[11]
In the United States, moxifloxacin is licensed for the treatment of acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, complicated and uncomplicated infections of the skin and of the skin structure, and complicated intra-abdominal infections.[12] In the European Union, it is licensed for acute bacterial exacerbations of chronic bronchitis, non-severe community-acquired pneumonia, and acute bacterial sinusitis. On the basis of its investigation into reports of rare but severe cases of liver toxicity and skin reactions, the European Medicines Agency recommended in 2008 that the use of the oral (but not the intravenous) form of moxifloxacin be restricted to infections in which other antibacterial agents cannot be used or have failed.[13] In the United States, the marketing approval does not contain these restrictions, though the label contains prominent warnings of skin reactions.
The initial approval by the Food and Drug Administration of the United States (December 1999)[14] encompassed these indications:
Additional indications approved by the Food and Drug Administration:
The European Medicines Agency has advised that, for pneumonia, acute bacterial sinusitis, and acute exacerbations of COPD, it should be used only when other antibiotics are inappropriate.[19][20]
Oral and intravenous moxifloxacin have not been approved for children. Several drugs in this class, including moxifloxacin, are not licensed by the Food and Drug Administration for use in children, because of the risk of permanent injury to the musculoskeletal system.[21][22][23] Moxifloxacin eye drops are approved for conjunctival infections caused by susceptible bacteria.[24]
Recently, alarming reports of moxifloxacin resistance rates among anaerobes have been published. In Austria 36% of Bacteroides have been reported to be resistant to moxifloxacin,[25] while in Italy resistance rates as high as 41% have been reported.[26]
- Acute exacerbations of chronic bronchitis
- Acute bacterial sinusitis
- Community-acquired pneumonia
- April 2001: Uncomplicated skin and skin-structure infections[15]
- May 2004: Community-acquired pneumonia caused by multidrug-resistant Streptococcus pneumoniae[16]
- June 2005: Complicated skin and skin-structure infections[17]
- November 2005: Complicated intra-abdominal infections[18]
Susceptible bacteria
- Staphylococcus aureus
- Staphylococcus epidermidis
- Streptococcus pneumoniae
- Stenotrophomonas spp.
- Yersinia spp.
- Haemophilus influenzae
- Klebsiella spp.
- Moraxella catarrhalis
- Enterobacter spp.
- Mycobacterium spp.
- Bacillus anthracis
- Mycoplasma genitalium[27]
- Borrelia Burgdoferi (found to be effective in vitro)
