Name: Moxifloxacin hydrochloride
MF: C21H25ClFN3O4
MW: 437.89
CAS No.: 186826-86-8
EP6.0 & BP2008
Moxifloxacin is a synthetic fluoroquinolone antibiotic agent. Bayer AG developed the drug (initially called BAY 12-8039) and it is marketed worldwide (as the hydrochloride) under the brand name Avelox (in some countries also Avalox) for oral treatment. Each tablet contains 400 mg. In most countries the drug is also available in parenteral form for intravenous infusion. Moxifloxacin is also sold in an ophthalmic solution (eye drops) under the name Vigamox for the treatment of conjunctivitis.
Mode of action
Moxifloxacin inhibits bacterial topoisomerase II (DNA gyrase) and topoisomerase IV. Topoisomerases are essential enzymes which play a crucial role in the replication and repair of bacterial DNA. This mechanism is lethal to susceptible bacteria. Moxifloxacin is often referred to as a chemotherapeutic drug because its mode of action has so far not been noted in any naturally occurring or semi-synthetic antibiotic.
Distribution
With either oral or intravenous administration, moxifloxacin is found in high concentrations in body tissues and fluids, such as saliva, nasal and bronchial secretions, sinus mucosa, skin blister fluid, and subcutaneous and intraocular tissues. There is good penetration into bone.Pus does not seem to easily inhibit the drug's potential to reach effective concentrations in infectious foci. Moxifloxacin does not reach appreciable levels in the kidney or urinary tract.
Susceptible bacteria
A broad spectrum of bacteria is susceptible including, but not limited to:
Staphylococcus aureus
Staphylococcus epidermidis
Streptococcus pneumoniae
Haemophilus influenzae
Klebsiella spp.
Moraxella catarrhalis
Enterobacter spp.
Mycobacterium spp.
Bacillus anthracis
Pharmacokinetic behaviour in patients with decreased liver and renal function
Mild, moderate and severe renal dysfunction does not alter half-life, metabolization or excretion significantly. The same is true to for mild to moderate liver impairment (Child-Pugh class A and B). Nothing is known about severe liver impairment (Child-Pugh class C).
Uses
Moxifloxacin can be used to treat respiratory infections, including acute sinusitis, acute exacerbations of chronic bronchitis, and community-acquired pneumonia, as well as skin and skin structure infections. Moxifloxacin is also used for the treatment of complicated intra-abdominal infections, such as those seen in hospitals. Because moxifloxacin is primarily metabolized and eliminated via the hepatic route, it is not indicated for the treatment of urinary tract infections.
Moxifloxacin is used as a second-line agent in tuberculosis (TB) and may potentially have benefits in reducing treatment duration from its current six month to four months.
In ophthalmology, moxifloxacin is available the form of eye drops, marketed by Alcon as Vigamox, to treat conjunctival infections caused by susceptible bacteria and to prevent infection following eye surgeries such as LASIK.
