Peripheral Neuropathy Causes Acronym

Medical School Antibiotics Fluoroquinolones

Hey this is K from imedicalschool hereto talk about a class of antibiotics called fluoroquinolones. The fluoroquinolones thatare commenly used within the outpatient and inpatient setting include ofloxacin, ciprofloxacin,levofloxacin, moxifloxacin and norfloxacin. The flurorquinolone groups of antibioticshave an interesting property compared to other antibiotics as these are the only antibioticsthat directly inhibit bacterial DNA synthesis. How do the fluoruquinolones inhibit bacterialDNA synthesis? Well these antibiotics work on the enzymesDNA gyrase and topoisomerase four. These enzymes are involved in the winding and unwindingof DNA. DNA gyrase and topoisomerase four

aid the unwinding of DNA so it can be readand replicated. With the inhibition of these enzymes, bacteria are unable to replicateand more importantly are unable to produce proteins that they need for survival. As aresult the fluorquinolone class of antibiotics are bacteriacidal meaning they actually leadto bacteria cell death. Now what organisms are targeted by fluoruquinoloneantibiotics? All the fluoruquinolones generally affect aerobic gram negative bacilli and gramnegative cocci. Examples of gram negative bacilli include enterobacteriaceia and haemophilus.Examples of gram negative cocci include Neisseria and Moraxella. In addition fluoruquinolonescan also work against pseudomonas and staph

aureus. Now the strength of each of the fluoruquinoloneson bacteria vary from each medication. For example norfloxacin, ciprofloxacin, and ofloxacinhave poor activity against streptococci and many anaerobes. Moxifloxacin has greater activityagainst anaerobes. Both levofloxacin and moxifloxacn have good activity against gram positive cocci. In terms of treating Pseudomonas, ciprofloxacintends to have the best activity against pseudomonas . Moxifloxacin and levofloxacin tend to haveless antipseudomonal activity. Now ciprofloxacin is so frequently used that many areas of thecountry have seen a significant surge of pseudomonas

resistance to ciprofloxacin so it is importantto know what are the bacterial resistances that are present in your community. In terms fo respiratory infections all thefluoruuquinolones are generally efffecive, however, both levofloxain and moxifloxacinhave better strep pneumoniae coverage than the other fluoruoquinolones. Now that we talked about the bacterial coverageof the fluoroquinolones it is important to talk about how these drugs are absorbed andcleared from the body. Fluorquinolones are absorbed well in the uppergastrointestinal tract. One of their advantages

is that they have a bioavailability that exceeds50 percent and actually reaches 100 percent in some. Meaning for some fluoroquinolonesadministering iV provides no greater bioavailability than administering it orally. Specificallybioavalabiltiy for ciprofloxain is 70%, gt; 95 percent for ofloxacin and levofloxacin withgreater than 85 percent bioavailability for moxifloxacin Though the fluoroquinolones are absorbed throughthe GI tract they have different routes of elimination. Ofloxacin and levofloxacin arerenally eliminated. Moxifloxacin is eliminated predominately by the liver and ciprofloxacinis excreted by both pathways

It is important when administering any medicationthat one understands the risks and adverse effects of the medication. In pregnant womenFluoroquinolones have not been established as safe and more research needs to be done.That being said quinolones should be avoided in children less than 18 ears old becausethere have been reports of joint cartilage erosions in animal studies . The concernsare these antibiotics can lead to detrimental outcomes on a child's growth. What are the side effects associated withfluoruoquibnolone use? Fluoruquinolones are associated with an increaserisk of developing c. diff colitis as these

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