VA Class: OP210
Chemical Name: (±-1-Cyclopropyl-6-fluoro-1,4-dihydro-8-methoxy-7-(3-methyl-1-piperazinyl)-4-oxo-3-quinoline- carboxylic acid sesquihydrate
Molecular Formula: C19H22FN3O4
CAS Number: 112811-59-3
Medically reviewed on May 22, 2017
Uses for Gatifloxacin
Bacterial Ophthalmic Infections
Many cases of mild, acute bacterial conjunctivitis resolve spontaneously without anti-infective therapy.6 17 18 19 Although topical ophthalmic anti-infectives may shorten time to resolution and reduce severity and risk of complications,6 8 17 18 19 avoid indiscriminate use of topical anti-infectives.6 17
Treatment of acute bacterial conjunctivitis generally is empiric;6 17 18 use of a broad-spectrum topical ophthalmic antibacterial usually recommended.6 17 18 In vitro staining and/or cultures of conjunctival material may be indicated in diagnosis and management of recurrent, severe, or chronic purulent conjunctivitis or when acute conjunctivitis does not respond to initial empiric topical treatment.6 17 18
Gatifloxacin Dosage and Administration
Bacterial Ophthalmic Infections
Children ≥1 year of age: Instill 1 drop of 0.5% solution in the affected eye(s) every 2 hours while awake (up to 8 times daily) on day 1, then 1 drop 2–4 times daily while awake on days 2 through 7.1 2
Bacterial Ophthalmic Infections
Cautions for Gatifloxacin
Hypersensitivity to gatifloxacin, other quinolones, or any ingredient in the formulation.1
Hypersensitivity reactions, including anaphylactic reactions, angioedema (e.g., pharyngeal, laryngeal, or facial edema), dyspnea, urticaria, and itching, reported in patients receiving gatifloxacin ophthalmic solution.1 Stevens-Johnson syndrome reported rarely.1
Hypersensitivity reactions have occurred following a single dose.1
Immediately discontinue at first sign of rash or hypersensitivity reaction.1
Corneal endothelial cell injury may occur if gatifloxacin ophthalmic solution is introduced directly into anterior chamber of the eye.1
Do not wear contact lenses during treatment with gatifloxacin ophthalmic solution or if any signs or symptoms of bacterial conjunctivitis are present.2
Common Adverse Effects
Interactions for Gatifloxacin
No formal drug interaction studies using gatifloxacin 0.5% ophthalmic solution.2
Serum concentrations of gatifloxacin were undetectable (<5 ng/mL) after topical application to one eye of gatifloxacin 0.5% ophthalmic solution in an escalated dosage regimen (2 drops initially, then 2 drops 4 times daily for 7 days, and then 2 drops 8 times daily for 3 days).1 2
Actions and Spectrum
Spectrum of activity includes gram-positive aerobic bacteria and some gram-negative aerobic bacteria.1
Advice to Patients
Advise patients not to wear contact lenses during treatment with gatifloxacin ophthalmic solution or if any signs or symptoms of bacterial conjunctivitis are present.2
Advise patients to immediately discontinue gatifloxacin ophthalmic solution and contact a clinician at first sign of rash or hypersensitivity reaction.1
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Gatifloxacin 0.5% Ophthalmic Solution
AHFS DI Essentials. © Copyright 2018, Selected Revisions May 22, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
1. Allergan, Inc. Zymaxid (gatifloxacin) ophthalmic solution 0.5% prescribing information. Irvine, CA; 2016 Sep.
2. Lupin Pharmaceuticals, Inc. Gatifloxacin ophthalmic solution 0.5% prescribing information. Baltimore, MD; 2016 May.
3. Heller W, Cruz M, Bhagat YR et al. Gatifloxacin 0.5% administered twice daily for the treatment of acute bacterial conjunctivitis in patients one year of age or older. J Ocul Pharmacol Ther. 2014; 30:815-22. http://www.ncbi.nlm.nih.gov/pubmed/25244402?dopt=AbstractPlus
4. Mah FS. New antibiotics for bacterial infections. Ophthalmol Clin North Am. 2003; 16:11-27. http://www.ncbi.nlm.nih.gov/pubmed/12683245?dopt=AbstractPlus
5. Zhanel GC, Ennis K, Vercaigne L et al. A critical review of the fluoroquinolones: focus on respiratory tract infections. Drugs. 2002; 62:13-59. http://www.ncbi.nlm.nih.gov/pubmed/11790155?dopt=AbstractPlus
6. Barnes SD, Kumar NM, Pavin-Langston D et al. Microbial Conjunctivitis. In: Bennett JE, Dolin R, and Blaser MJ, eds. Mandell, Douglas, and Bennett's principles and practices of infectious diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:1392-1401.
8. Thielen TL, Castle SS, Terry JE. Anterior ocular infections: an overview of pathophysiology and treatment. Ann Pharmacother. 2000; 34:235-46. http://www.ncbi.nlm.nih.gov/pubmed/10676832?dopt=AbstractPlus
9. Bearden DT, Danziger LH. Mechanism of action of and resistance to quinolones. Pharmacotherapy. 2001; 21:224S-32S. http://www.ncbi.nlm.nih.gov/pubmed/11642689?dopt=AbstractPlus
12. Robert PY, Adenis JP. Comparative review of topical ophthalmic antibacterial preparations. Drugs. 2001; 61:175-85. http://www.ncbi.nlm.nih.gov/pubmed/11270936?dopt=AbstractPlus
17. American Academy of Ophthalmology. Preferred practice pattern (PPP) guidelines: conjunctivitis PPP - 2013. From American Academy of Ophthalmology website. Accessed 17 Oct 2016. http://www.aao.org/preferred-practice-pattern/conjunctivitis-ppp--2013
18. Azari AA, Barney NP. Conjunctivitis: a systematic review of diagnosis and treatment. JAMA. 2013; 310:1721-9. http://www.ncbi.nlm.nih.gov/pubmed/24150468?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=4049531&blobtype=pdf
19. Sheikh A, Hurwitz B, van Schayck CP et al. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012; :CD001211.
20. Hooper DC, Strahilevitz J. Quinolones. In: Bennett JE, Dolin R, and Blaser MJ, eds. Mandell, Douglas, and Bennett's principles and practices of infectious diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:419-39.
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