Gatifloxacin

 Action Treatment of infections caused by susceptible strains of the designated microorganism.

 Indications For treatment of bacterial infections including chronic bronchitis; acute sinusitis; community-acquired pneumonia; uncomplicated and complicated urinary tract infections (UTIs); pyelonephritis; uncomplicated urethral and cervical gonorrhea; uncomplicated rectal infections in women. Unlabeled use(s): Atypical pneumonia; uncomplicated skin/soft tissue infections and chronic prostatitis.

 Contraindications Tendonitis or tendon rupture associated with quinolone use.

 Route/Dosage

Acute Bacterial Exacerbation of Chronic Bronchitis

PO/IV 400 mg q 24 hr x 7 to 10 day.

Acute Sinusitis

PO/IV 400 mg q 24 hr x 10 day.

Community-Acquired Pneumonia

PO/IV 400 mg q 24 hr x 7 to 14 day.

Uncomplicated UTIs (Cystitis)

PO/IV 400 or 200 mg q 24 hr. Single dose x 3 day.

Complicated UTIs

PO/IV 400 mg q 24 hr x 7 to 10 day.

Acute Pyelonephritis

PO/IV 400 mg q 24 hr x 7 to 10 day.

Uncomplicated Urethral Gonorrhea in Men; Endocervical and Rectal Gonorrhea in Women

PO/IV 400 mg q 24 hr in a single dose.

Renal Impairment

ADULTS EMPH: CrCl > 40 mL/min PO/IV 400 mg initial dose then subsequent dose of 400 mg. PO/IV q 24 hr (on day 2 of dosing). ADULTS EMPH: CrCl < 40 mL/min PO/IV 400 mg initial dose then subsequent dose of 200 mg PO/IV q 24 hr (on day 2 of dosing).

Hemodialysis; Continuous Peritoneal Dialysis

400 mg PO/IV initial dose then subsequent dose of 200 mg PO/IV q 24 hr (on day 2 of dosing).

 Interactions

Aluminum- and magnesium-containing antacids, didanosine-buffered tablets, iron or zinc salts: May decrease the bioavailability of gatifloxacin. Digoxin: Plasma level of digoxin may be elevated, increasing the risk of toxicity. Probenecid: Renal clearance of gatifloxacin may be decreased, prolonging the half-life and increasing plasma levels of gatifloxacin. INCOMPATIBILITIES: Amphotericin B; amphotericin B cholesteryl sulfate; cefoperazone sodium; cefonicid; cefozitin sodium; diazepam; furosemide; heparin sodium; mezlocillin disodium; phenytoin sodium; piperacillin sodium/tazobactam sodium; potassium phosphates; vancomycin in 5% Dextrose Injection.

 Lab Test Interferences None well documented.

 Adverse Reactions

Cardiovascular Palpitations. CNS: Abnormal dream; insomnia; paresthesia; tremors; vasodilation; vertigo. DERM: Rash; sweating. GI: Abdominal pain; constipation; dyspepsia; glossitis; oral moniliasis; stomatitis; mouth ulcer; vomiting. GU: Dysuria; hematuria. META: Peripheral edema. RESPIRATORY: Dyspnea; pharyngitis. EENT: Abnormal vision; tinnitus. OTHER: Allergic reaction; chills; fever; back pain; chest pain; taste perversion.

 Precautions

Pregnancy: Category C. Lactation: Not known if excreted in human milk. Children: Safety and efficacy not established in patients < 18 yr. Special-risk patients: Renal insufficiency. Hypersensitivity: Mild to life-threatening. Discontinue drug at first sign of hypersensitivity reaction.

 Administration/Storage

Oral

• Administer oral gatifloxacin > 4 hr before the administration of ferrous sulfate; dietary supplements containing zinc, magnesium, or iron (such as multivitamins); aluminum/magnesium-containing antacids; or didanosine-buffered tablets, buffered solution, or buffered powder or oral suspension.
• Administer without regard to food, including milk and dietary supplements containing calcium, and without regard to age (> 18 yr) or gender.

IV

• Administer injection by IV infusion only.
• Administer by IV over a period of 60 min. EMPH: Caution: Avoid rapid or bolus IV infusion.
• Single-use vials require dilution prior to administration.
• When switching from IV to oral administration, no dosage adjustment is necessary. Patients whose therapy is started with the injection may be switched to tablets when clinically indicated.

 Assessment/Interventions

&NA;

 Patient/Family Education

• Instruct patient to stop treatment and inform physician if experiencing pain, inflammation, or rupture of tendon, and to rest or refrain from exercise until diagnosis of tendonitis or tendon rupture has been excluded.