Fluoroquinolones Available as Oral Suspensions in Malaysia
Based on the available evidence, ofloxacin is the only fluoroquinolone available as an oral suspension in Malaysia. 1
Available Fluoroquinolone Suspensions
The evidence indicates that ofloxacin is available as an oral suspension formulation in Malaysia, while other fluoroquinolones are not available in this dosage form. According to the CDC/MMWR guidelines, "ofloxacin suspension for oral liquid administration is not available in the United States" 1, implying its availability in other countries, including Malaysia.
Key points about ofloxacin oral suspension:
- Ofloxacin is a second-generation fluoroquinolone with activity against both gram-negative and some gram-positive bacteria
- It can be administered at a dosage of 7.5 mg/kg every 12 hours orally (maximum 400 mg/dose) 1
- The suspension formulation is particularly valuable for pediatric patients and adults who have difficulty swallowing tablets
Other Fluoroquinolones and Their Formulations
While other fluoroquinolones exist in various formulations, they are not available as oral suspensions in Malaysia:
- Ciprofloxacin: Available as tablets and intravenous formulations, but not as an oral suspension in Malaysia
- Levofloxacin: Available as tablets and intravenous formulations
- Moxifloxacin: The guidelines note that "no commercial liquid formulation is available for moxifloxacin" 1, though hospitals and compounding pharmacies in some countries can prepare extemporaneous suspensions
Clinical Implications
The limited availability of fluoroquinolone oral suspensions has important clinical implications:
- For pediatric patients requiring fluoroquinolones, ofloxacin suspension provides an important option when tablets cannot be administered
- For patients with swallowing difficulties or those requiring administration via nasogastric tubes, the availability of only one fluoroquinolone in suspension form limits therapeutic options
- When treating infections requiring other fluoroquinolones, alternative administration routes or different antibiotic classes may need to be considered
Regulatory and Availability Considerations
It's important to note that drug availability can change based on regulatory decisions and pharmaceutical manufacturing practices. Healthcare providers should:
- Verify current availability with local pharmacies or the Malaysian Drug Control Authority
- Consider compounding options when specific fluoroquinolone suspensions are needed but commercially unavailable
- Be aware that fluoroquinolone use in children should be limited due to potential adverse effects on developing cartilage 1
For patients requiring fluoroquinolone therapy who cannot take tablets, ofloxacin suspension represents the only commercially available option in Malaysia.