From the Guidelines
The standard dosage of injectable moxifloxacin is 400 mg administered intravenously once daily, as recommended by the most recent guidelines 1. This dose is typically infused over 60 minutes and does not require adjustment for most adult patients with normal renal function. The dosage of moxifloxacin is also supported by another study 1, which lists the initial intravenous adult dosages of antibiotics for empiric treatment of complicated intra-abdominal infection, including moxifloxacin at 400 mg every 24 hours.
- Key points to consider when administering moxifloxacin include:
- Monitoring for potential side effects, such as QT prolongation, tendon inflammation, and CNS effects
- Maintaining adequate hydration during treatment
- Administering the medication at approximately the same time each day to maintain consistent blood levels
- Considering dosage individualization based on serum drug-concentration monitoring, especially for patients with renal or hepatic impairment
- The broad-spectrum activity of moxifloxacin against gram-positive, gram-negative, and anaerobic organisms makes it a suitable option for treating various infections, including community-acquired pneumonia, complicated skin infections, and intra-abdominal infections.
- It is essential to note that moxifloxacin should be used cautiously in patients with risk or suspicion of tuberculosis, as it may delay the diagnosis of pulmonary tuberculosis and increase the risk of fluoroquinolone resistance 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Moxifloxacin Dosage
- The recommended dosage of moxifloxacin is 400 mg once daily, as stated in the studies 2, 3, 4, 5, 6.
- This dosage is applicable for various infections, including acute exacerbations of chronic bronchitis, community-acquired pneumonia, acute bacterial sinusitis, and uncomplicated skin and skin structure infections.
- The pharmacokinetics of moxifloxacin in critically ill patients with acute renal failure undergoing continuous venovenous haemodiafiltration (CVVHDF) is comparable to healthy subjects and patients without renal impairment, supporting the use of 400 mg once daily in these patients 2.
- A population pharmacokinetic evaluation of intravenous and enteral moxifloxacin in surgical intensive care unit patients also supports the use of 400 mg once daily, as it reliably attains the pharmacokinetic/pharmacodynamic target values for community-acquired pneumonia and hospital-acquired pneumonia 5.
Special Considerations
- The safety profile of moxifloxacin is considered favorable, with overall incidence rates of adverse events similar to comparator groups 3.
- However, rare but potentially fatal toxicities, such as hepatic, cardiac, or skin reactions, have been reported 3.
- Moxifloxacin penetrates and accumulates in intra-abdominal abscess fluid, making it a good candidate therapy for use in patients with intra-abdominal abscesses undergoing CT-guided percutaneous drainage 6.
Administration
- Moxifloxacin can be administered intravenously or enterally, with a bioavailability of 76% after enteral administration 5.
- The standard dosing provides sufficient drug exposure for treatment of community-acquired pneumonia, but for hospital-acquired pneumonia, it only provides sufficient exposure when a highly susceptible pathogen is present 5.