What is Ofloxacin (Fluoroquinolone antibiotic)?

From the Guidelines

Ofloxacin should not be used as a first-line treatment for most bacterial infections due to increasing resistance rates and potential side effects, as recommended by recent guidelines 1.

Overview of Ofloxacin

Ofloxacin is a fluoroquinolone antibiotic that works by inhibiting bacterial DNA gyrase and topoisomerase IV, leading to bacterial cell death. It is effective against various bacterial infections, including respiratory tract infections, urinary tract infections, skin infections, and certain sexually transmitted infections.

Dosage and Administration

The typical dosage of ofloxacin for adults is 200-400 mg twice daily, with treatment duration ranging from 3-14 days depending on the infection type. However, the dosage and administration may vary depending on the specific infection and patient population.

Side Effects and Contraindications

Common side effects of ofloxacin include nausea, diarrhea, headache, and dizziness. More serious concerns include tendon damage, peripheral neuropathy, and central nervous system effects. Ofloxacin is contraindicated in pregnant women, children, and patients with myasthenia gravis or history of tendon disorders.

Resistance and Guideline Recommendations

Recent guidelines recommend against the use of ofloxacin as a first-line treatment for most bacterial infections due to increasing resistance rates and potential side effects 1. The World Health Organization and other health organizations have reported high resistance rates to fluoroquinolones, including ofloxacin, in many parts of the world. Therefore, alternative antibiotics should be considered as first-line treatment options.

Alternative Treatment Options

Alternative treatment options for bacterial infections include other classes of antibiotics, such as cephalosporins, macrolides, and aminoglycosides. The choice of antibiotic should be based on the specific infection, patient population, and local resistance patterns.

Key Points

• Ofloxacin is a fluoroquinolone antibiotic effective against various bacterial infections
• Increasing resistance rates and potential side effects limit its use as a first-line treatment
• Alternative antibiotics should be considered as first-line treatment options
• Dosage and administration may vary depending on the specific infection and patient population
• Patients should report any unusual symptoms promptly and complete the full course of treatment even if symptoms improve before completion 1.

From the FDA Drug Label

Following oral administration of recommended therapeutic doses, ofloxacin has been detected in blister fluid, cervix, lung tissue, ovary, prostatic fluid, prostatic tissue, skin, and sputum. The distribution of ofloxacin in the body includes various body fluids and tissues, with mean concentrations 0.8 to 1.5 times the concurrent plasma level.

• Body fluids and tissues where ofloxacin has been detected include:
  • Blister fluid
  • Cervix
  • Lung tissue
  • Ovary
  • Prostatic fluid
  • Prostatic tissue
  • Skin
  • Sputum Inadequate data are available on the distribution of ofloxacin in cerebrospinal fluid or brain tissue 2.

From the Research

Overview of Ofloxacin

• Ofloxacin is a fluoroquinolone antibacterial agent with a broad range of activity against Gram-positive and Gram-negative organisms 3.
• It has favorable pharmacokinetics with almost 100% bioavailability and peak serum concentrations obtained one to two hours following oral dosing 3.
• Ofloxacin has demonstrated bacteriologic and clinical efficacy in the treatment of urinary tract infections, respiratory tract infections, prostatitis, and skin and soft tissue infections caused by susceptible organisms 3.

Comparison with Other Antibiotics

• Ofloxacin has a similar antimicrobial spectrum to ciprofloxacin, but with lower MIC90 values for S aureus, C trachomatis, and Ureaplasma urealyticum 3.
• Levofloxacin, the optically pure levorotatory isomer of ofloxacin, has improved activity against Streptococcus pneumoniae compared with ciprofloxacin or ofloxacin 4.
• Ofloxacin is the only quinolone currently approved for the treatment of uncomplicated gonorrhea 3.

Clinical Efficacy

• Ofloxacin has been shown to be effective in the treatment of urinary tract infections, with clinical efficacy demonstrated in acute and chronic infections 5.
• Levofloxacin, a derivative of ofloxacin, has been shown to be effective in the treatment of community-acquired pneumonia, acute exacerbations of chronic bronchitis, and skin and skin structure infections 6, 4, 7.
• Ofloxacin has also been used to treat prostatitis, and skin and soft tissue infections, with favorable results 3.

Safety and Tolerability

• Ofloxacin has a good safety profile, but should not be used in children or in pregnant or nursing women 3.
• Levofloxacin has been involved in only a few case reports of adverse events, including QTc prolongation, seizures, glucose disturbances, and tendonitis 7.
• Ofloxacin is well tolerated, with bacterial resistance not appearing to develop readily 5.