Skin and skin structure infections: treatment with newer generation fluoroquinolones

Figures & data

Table 1 Newer generation fluoroquinolones: basic facts

Quinolone	Typical dose	Route of administration	Metabolism	Half life	Unique features
Levofloxacin	500–50 mg	IV or PO	Renal	6–9 hours
Moxifloxacin	400 mg	IV or PO	Hepatic conjugation	12 hours	Anaerobic coverage
Gatifloxacin	400 mg	IV or PO	Renal	7–14 hours	Dysglycemia

Figure 1 Prevalence of causative pathogens in complicated skin infections.

Reference: Rennie et al. 2003.

Table 2 AUC/MIC90 ratios for various flouroquinolones against Staphylococcus aureus

Quinolone	Dose (mg)	AUC (mcg.·hr/mL)	MIC90 (mcg/mL)
Gatifloxacin	400	32.9	0.125
Levofloxacin	500	45.6	0.5
Levofloxacin	750	82.6	0.5

Adapted from Firsov AAC 2005;49:2642 (AUC data) and Blondeau Int J Antimicrobial Agents 2003;22:147 (MIC90data)

Table 3 Summary of clinical trials of newer generation fluoroquinolones for skin and skin structure infections

Author and year	Type of skin infection	Study drug and dosing	Duration of therapy	Clinical cure rate	Bacteriological cure rate
Parrish 2005	Uncomplicated	Moxifloxacin 400 mg PO daily	7 days	90%	92%
Giordano et al 2005	Complicated	Moxifloxacin 400 mg IV/PO daily	7–14 days	79%	78%
Tarshis et al 2001	Uncomplicated	Gatifloxacin 400 mg PO daily	7–10 days	91%	91%
Tarshis et al 2001	Uncomplicated	Levofloxacin 500 mg PO daily	7–10 days	84%	84%
Nichols et al 1997	Uncomplicated	Levofloxacin 500 mg PO daily	7–10 days	98%	98%
Graham et al 2002	Complicated	Levofloxacin 750 mg IV/PO daily	7–14 days	84%	91%

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