Ciprofloxacin                Levofloxacin                 Gatifloxacin                     Moxifloxacin                 Gemifloxacin

Organism

MIC₅₀

MIC₉₀

MIC₅₀

MIC₉₀

MIC₅₀

MIC₉₀

MIC₅₀

MIC₉₀

MIC₅₀

MIC₉₀

Gram-Negatives

Acinetobacter baumannii

0.5-32

>16

0.25-4

8-16

0.12-4

8-16

0.12-8

16-32

0.12-8

16 - >16

Enterobacter cloacae

0.008-0.03

0.016-1

£0.03 - 0.06

0.03-1

0.03-0.06

0.03-1

0.06

0.125-0.25

0.016-0.03

0.03-0.5

Escherichia coli

0.008- 0.03

0.03-1

0.015- 0.03

0.06-0.5

0.016-0.3

£0.03-0.5

0.03-0.06

0.06-1

0.008- 0.016

0.03-0.5

Haemophilus influenzae

0.008-0.015

0.015-0.03

0.015

0.015-0.06

0.008-0.015

0.015-0.03

0.015-0.03

0.06-0.03

0.002-0.004

0.008-0.03

Klebsiella pneumoniae

0.016- 0.06

0.06-2

≤0.03-0.06

0.25-2

0.03-0.06

0.06-1

0.06- 0.25

0.125-1

0.03-0.06

0.125-1

Moraxella catarrhalis

0.03-0.06

0.03-0.06

0.03-0.06

0.06

0.03

0.03-0.06

0.03-0.12

0.06-0.12

0.008-0.015

0.008-0.03

Morganella morganii

0.008-0.016

0.015-2

0.031

0.125- 0.25

0.25

0.25

0.12-0.25

0.25-0.5

0.06

0.125-4

Neisseria gonorrhoeae

0.004-0.5

0.004-0.5

0.008-0.5

0.12-0.5

0.12

0.25

0.008-0.25

0.015-0.5

0.004-0.12

0.06-0.5

Neisseria meningitidis

≤0.002-0.008

0.004-0.008

0.008

0.008

0.004-0.008

0.008

0.008

0.008-0.015

0.004-0.008

0.008

Proteus mirabilis

0.03-0.06

0.03- 2

0.03-0.5

0.12-2

0.12-0.25

2-4

0.25-1

0.25-8

0.12-0.25

0.25-8

Pseudomonas aeruginosa

≤0.25-1

4 - >16

1-4

>4 - 16

1-4

>4

2-16

8

0.5-4

>4 - >16

Serratia

marcescens

0.06-0.25

0.5-4

0.125

0.25-2

0.25

2

0.25

4

0.125-0.25

1-2

Salmonella spp.

0.016-0.12

0.03-

0.25

£0.03-0.06

0.25 - 0.5

£0.03- 0.06

0.06-0.25

0.12

1

0.016-0.03

0.016- 0.12

Stenotrophomonas maltophilia

2-4

8-16

0.5-1

4-8

0.5-1

4-8

0.5-1

2-4

0.5-2

4-8

Gram-Positives

Staphylococcus aureus

0.5-1

0.5 - >4

0.125-0.25

0.25 - >4

0.06-0.12

0.12 - >4

0.06

0.06-2

NA

0.06-8

MS S. aureus

0.25-1

0.5-4

0.12-0.25

0.25-2

0.06-0.12

0.125-0.5

0.03-0.12

0.06-0.25

0.015-0.06

0.03-0.12

MR S. aureus

1 - >16

16 - >128

0.25-32

8 - >128

0.125-8

4 - >128

0.06 - 2

2-128

0.03-4

2 - >128

Streptococcus pneumoniae

1-2

2-16

0.5-1

1-2

0.25-0.5

0.5

0.03-0.25

0.12-0.25

0.015-0.03

0.03-0.06

Penicillin susceptible

1-2

2-4

0.5-1

1-2

0.25

0.5

0.125-0.25

0.25

0.015-0.03

0.03-0.06

Penicillin intermediate

1-2

2-4

0.5-1

1-2

0.25

0.5

0.125-0.25

0.12-0.25

0.015-0.03

0.03-0.06

Penicillin

resistant

1-2

2-4

0.5-1

1-2

0.25-0.5

0.25-0.5

0.125-0.25

0.12-0.25

0.015-0.03

0.03-0.06

Viridans Streptococcus

1-2

4

1

1-2

0.25-0.5

0.5-1

0.25

0.25-0.5

0.03-0.06

0.06-0.25

S. agalactiae

0.25-1

1-2

0.5

0.5-1

0.25-0.5

0.25-0.5

0.125 – 0.25

0.25

0.03-0.06

0.03-0.25

S. pyogenes

0.25-1

1

0.25-0.5

0.5-1

0.12-0.25

0.25-0.5

0.06-0.25

0.25-0.5

0.016-0.06

0.03-0.25

Enterococcus faecalis

0.5-2

1 - >16

1

³8 - >16

0.5-1

1-16

0.12-0.5

0.25 - ³4

0.06-0.25

2 - ³4

Enterococcus faecium

2 - >16

4 - >128

³8->16

³8->16

2 - ³16

³16

2 - 32

2 - >32

³4 - >16

³4 - >16

Anaerobes

Bacteroides fragilis

4

32

1-2

4-16

0.25-1

1-4

0.125-1

1-4

0.5 - 1

2 - 16

Clostridium difficile

8-16

16-64

4

4 - >16

1

2

1

2

1-2

2 - >16

Fusobacterium spp.

1- 4

2-16

1

1-8

0.25-1

0.25-8

0.25-0.5

2-4

≤0.25 - 4

0.5-8

Peptostreptococcus spp.

1

2

0.5-4

4

0.5

1

0.06-0.5

0.12-1

0.03-0.12

0.06-2

Porphyromonas spp.

0.5

2

0.25

1

0.125

0.25

£0.03-0.25

£0.03-0.25

0.06

0.125

Prevotella spp.

1-4

2-64

0.5-1

1-8

0.25-0.5

0.5-4

0.125-0.5

0.25-2

1-4

2-16

Miscellaneous

Mycobacterium tuberculosis

0.125-2

0.125-4

0.125-0.5

0.125-1

0.03-0.12

0.03-0.25

0.25-0.6

0.125-1

4

8

Mycoplasma pneumoniae

1

1-2

0.25-0.5

0.5-1

0.06

0.12

0.06

0.06-0.12

NA

0.25

Chlamydia pneumoniae

0.5

2

0.25-0.5

0.5-1

0.06-0.25

0.125-0.25

0.06-1

0.5-1

0.25

0.25

Legionella pneumophila

0.016-0.03

0.016-0.06

0.008-0.016

0.008-0.016

0.008-0.016

0.016-0.03

0.008-0.016

0.008-0.03

0.008-0.03

0.016-0.03

Parameter

Norfloxacin

Ciprofloxacin

Oflox/Levofloxacin

Gatifloxacin

Trovafloxacin

Moxifloxacin

Gemifloxacin

Dose (mg)

400

750

400/500

400

300

400

320

Peak (mg/mL)

1.5

3.5

4.0/6.0

3.4

4.0

4.5

1.6

Peak / 100 mg dose

0.38

0.46

1.0/1.2

0.85

1.32

1.12

0.5

Protein bound (%)

15

25

25

18

70

50

60

Vdss (L/kg)

1.7

3.2

1.45

1.7

1.1

2.7

4.18

t ½ (h)

(CrCl 100 mL/min)

3.3

4.0

6.0

8.4

10.0

12.7

6.1

t ½ (h)

(CrCl 10 mL/min)

8.0

10.0

30.0

>40

12

14.5

NA

AUC (mg∙h/mL)

13.6

29

38/58

32

41.4

48.0

9.1

AUC / 100 mg dose

1.7

1.9

11.7

8

13.8

12

2.8

Cl_renal (mL/min)

234

250

190

NA

10

43

134

% Nonrenal

60

40

5

10

90

80

64

% Renal

40

60

95

90

10

20

22

Bioavailability (%)

40

70

99

96

88

86

71

Site

Dose

Route

Frequency

Time to C_tissue

Conc. Tissue

Time to C_plasma

Conc. Plasma

Reference

Ciprofloxacin

Bile

500 mg

po

bid x 6

25-26 h

4.5 mg/L

4h

2.5

(64)

Blister, suction

500 mg

1 x

84.70%

2.26

(145)

Lung, parenchyma

200 mg

iv

1 x

3.4 mcg/g

0.6

(44)

Lung, pleura

200 mg

iv

1 x

1.7 mcg/g

0.6

(44)

Muscle, heart valve

750 mg

po

q 12h x 4

1-3 h

8.3/3.1 mcg/g

11.59/3.95

(170)

Muscle, myocardium

400 mg

iv

1 x

1 h

31.6/25 mcg/g

6.19/1.73

(170)

Prostate, TURP

200 mg

po

tid x 9

5.5 h

1.32/0.64

5.5 h

0.65/0.31

(177)

Levofloxacin

Bile

100 mg

po

1 x

2-6 h

0.49/5.63

2-6 h

0.55/1.63

(257)

Norfloxacin

Prostate, TURP

200 mg

po

tid x 5

4.42/1.94

(2.45/7.76) intraoperative

2.89/2.34

(0.87/8.33) intraoperative

(283)

Ofloxacin

Bone

300 mg

po

1 x

1 h

1.58/0.06 mcg/g

1 h

2.61/0/17

(194)

Lung, parenchyma

600 mg

po

1 x

2 h

17.7/9.2 mcg/g

2 h

8.7/4.2

(275)

Muscle, myocardium

400 mg

iv

1 x

1 h

8.89/2.16

15.9/2.5

(170)

Prostate, TURP

200 mg

po

tid x 5

5.51/1.79

(3.62-7.19) intraoperative

5.36/1.28

(3.12-8.24)

30 min preop

(283)

Moxifloxacin

Alveolar macrophages

400 mg

po

1 x

2.2 h

56.7

2.2 h

3.2

(247)

Bronchial mucosa

400 mg

po

1 x

2.2 h

1.29

2.2 h

3.2

(247)

Epithelial lining fluid

400 mg

po

1 x

2.2 h

20.7

2.2 h

3.2

(247)

Maxillary sinus mucosa

400 mg

po

qd x 5d

3 h

7.48

3 h

3.58

(87)

Blister

400 mg

iv

1 x

5.6 h

1.7

1 h

3.7

(178)

Skeletal muscle

400 mg

iv

1 x

1.8 h

1.2

1 h

3.7

(178)

Subcutaneous adipose

400 mg

iv

1 x

2 h

1.0

1 h

3.7

(178)

Gemifloxacin

Alveolar macrophages

320 mg

po

1 x

107

1.4

(203)

Bronchial mucosa

320 mg

po

1 x

9.52

1.4

(203)

Epithelial lining fluid

320 mg

po

1 x

2.69

1.4

(203)

Blister

320 mg

po

1 x

3.4 h

0.74

1.2 h

2.3

(86)

Indication

Agent

Regimen

Respiratory Infections

Acute community-acquired pneumonia

Moxifloxacin

400 mg q24h iv/po  x 7-14 days

Gemifloxacin

320 mg q24h po x 7 days

Gatifloxacin

400 mg q24h iv/po x 7-14 days

Ofloxacin

400 mg q12h iv/po x 10 days

Levofloxacin

500 mg q24 iv/po x 7-14 days

750 mg q24 iv/po  x 5 days

Lower Respiratory Tract Infections

Ciprofloxacin

500-750 mg q12h po / 400 mg q8-12h iv x 7-14 days

Acute Maxillary Sinusitis

Moxifloxacin

400 mg q24 iv/po  x 5 days

Ciprofloxacin

500 mg po q12h po / 400 mg q12h iv x 10 days

Levofloxacin

500 mg q12h iv/po x 10-14 days

Gatifloxacin

400 mg q24h iv/po x 10 days

Acute bacterial exacerbations of chronic bronchitis

Moxifloxacin

400 mg q24h iv/po x 5 days

Gemifloxacin

320 mg q24h po x 5 days

Levofloxacin

500 mg q24h iv/po x 7 days

Ofloxacin

400 mg q12h iv/po x 10 days

Gatifloxacin

400 mg q24h iv/po x 5 days

Nosocomial pneumonia

Ciprofloxacin +/- another agent

400 mg q8 iv x 10-14 days

Levofloxacin +/- another agent

750 mg q24h iv/po x 7-14 days

Urinary Tract Infections (UTI)

Acute Uncomplicated UTIs

Ciprofloxacin

250 mg q12h po x 3 days

Levofloxacin

250 mg q24h iv/po x 3 days

Gatifloxacin

400 mg iv/po single dose or 200 mg q24h iv/po x 3 days

Norfloxacin

400 mg q12h po x 3-10 days

Ofloxacin

200 mg q12h iv/po x 3-7 days

Complicated UTI and pyelonephritis

Levofloxacin

250 mg q24h iv/po x 10 days

Gatifloxacin

400 mg q24h iv/po x 7-10 days

Ciprofloxacin

500 mg q 12h po / 400 mg q12h iv x 7-14 days

Ofloxacin

200 mg q12h iv/po x 10 days

Norfloxacin

400 mg q12h po x 10-21 days

Prostatitis

Levofloxacin

500 mg q24h iv/po x 28 days

Ciprofloxacin

500 mg q12 h po / 400 mg q12h iv x 28 days

Norfloxacin

400 mg q12h po x 28 days

Ofloxacin

300 mg q12h iv/po x 6 weeks

Venereal Diseases

Uncomplicated gonococcal infections

Ciprofloxacin

500 mg po single dose

(Avoid in Asia/Pacific, Hawaii and California)

Ofloxacin

400 mg iv/po single dose

Levofloxacin

250 mg iv/po single dose

Gatifloxacin

400 mg iv/po single dose

Norfloxacin

400 mg po single dose

Urethritis due to C. trachomatis

Ofloxacin

300 mg q12h iv/po x 7 days

Levofloxacin

500 mg q24h x 7 days

Acute PID

Ofloxacin (+ metronidazole)

400 mg q12h iv/po x 10-14 days

Levofloxacin (+ metronidazole)

500 mg q24h iv/po x 10-14 days

Chancroid

Ciprofloxacin

500 mg q12h po x 3 days

Epididymitis due to enteric gram-negative organisms

Ofloxacin

300 mg q12h iv/po x 10 days

Levofloxacin

500 mg q24h iv/po x 10 days

Skin and Bone

Uncomplicated skin and skin structure infection

Moxifloxacin

400 mg q24h x 7 days

Ciprofloxacin

500-750 mg q12h po x 7-14 days

400 mg q8-12h iv

Levofloxacin

500 mg q24h iv/po x 7-10 days

Ofloxacin

400 mg q12h iv/po x 10 days

Gatifloxacin

400 mg q24h iv/po x 7-10 days

Complicated skin and skin structure infection

Levofloxacin

750 mg q24h iv/po x 7-14 days

Bone and Joint infection

Ciprofloxacin

500-750 mg q12h po x 4-6 weeks

400 mg q 8-12h iv

Abdominal infections

Intra-abdominal infection

Ciprofloxacin (+ metronidazole)

500 mg q12h po x 7-14 days

400 mg q12h iv

Infectious diarrhea

Ciprofloxacin

500 mg q12h x 3-5 days (current recommendations)

500 mg q12h po x 5-7 days (labeled)

Ofloxacin

300 mg q 12h x 3-5 days

Norfloxacin

400 mg q12h x 3-5 days

Typhoid Fever

Ciprofloxacin

500 mg q12h po x 10 days

Inhalational anthrax (post-exposure)

Ciprofloxacin

500 mg q 12h po x 60 days

Empiric therapy in febrile neutropenia

Ciprofloxacin (+ piperacillin)

400 mg q8h iv

Parameter

Norfloxacin

Ciprofloxacin

Oflox/Levofloxacin

Gatifloxacin

Trovafloxacin

Moxifloxacin

Gemifloxacin

GI Upset

+2

+2

+1

+3

+2

+3

+2

Photosensitivity

0

0

+1

+0

0

0

0

CNS Effects

+1

+1

+2

+2

+3

+1

+1

QTc prolongation

+1

+1

+1

+1

+1

+1

+1

Theophylline interaction

+1

+1

+1

0

0

0

0

Cation interaction

+4

+4

+2

+3

+1

+3

+4

Warfarin interaction

+2

+1

0

0

0

0

0