Pefloxacin

Absorption

Well absorbed by the oral route.

Toxicity

Adverse reactions include peripheral neuropathy, nervousness, agitation, anxiety, and phototoxic events (rash, itching, burning) due to sunlight exposure.

The Uses of Pefloxacin

Pefloxacin Mesylate Dihydrate is an analog of norfloxacin that inhibits topoisomerase.

The Uses of Pefloxacin

antibacterial;DNA gyrase inhibitor

Indications

For the treatment of uncomplicated gonococcal urethritis in males and for gram-negative-bacterial infections in the gastrointestinal system and the genitourinary tract.

Background

A synthetic broad-spectrum fluoroquinolone antibacterial agent active against most gram-negative and gram-positive bacteria.

Definition

ChEBI: A quinolone that is 4-oxo-1,4-dihydroquinoline which is substituted at positions 1, 3, 6 and 7 by ethyl, carboxy, fluorine, and 4-methylpiperazin-1-yl groups, respectively.

Pharmaceutical Applications

A 6-fluoro, 7-piperazinyl quinoline available for oral and intravenous administration. The in-vitro activity is very similar to that of norfloxacin . It is active against H. ducreyi, V. cholerae and Legionella spp., but Campylobacter and Acinetobacter spp. and pseudomonads are not susceptible. It has poor activity against pneumococci, chlamydiae, mycoplasmas and ureaplasmas. L. monocytogenes, Nocardia spp. and anaerobes are resistant.
A plasma concentration of c. 5 mg/L is achieved 1–1.5 h after a 400 mg oral dose. The plasma elimination half-life is 8.5–15 h. It is widely distributed, concentrations in bone, brain, blister fluid, CSF, saliva, sputum and prostate all approximating, and in some cases exceeding, the simultaneous plasma concentration. It is extensively metabolized to the desmethyl (= norfloxacin) and N-oxide derivatives. Some 60–70% of a dose, only about 10% of which is unchanged, appears in the urine; 25% of a dose appears in the feces, a small part contributed by elimination in the bile.
The half-life increases with hepatic impairment, but is virtually unaffected by renal failure. In patients on continuous ambulatory peritoneal dialysis (CAPD) given 800 mg followed by 400 mg every 12 h for 10–12 days, there was no significant accumulation of pefloxacin or its metabolite, norfloxacin, but concentrations of pefloxacin N-oxide rose continuously in plasma and dialysate; all concentrations fell rapidly when treatment was discontinued.
Adverse reactions are those common to the group . Most common are gastrointestinal tract disturbances, although some typical CNS reactions have been encountered. Skin eruptions (some photosensitive) occur and rashes appeared in about one-third of a group of patients who were given longterm therapy. Clinical uses are similar to those of ofloxacin.

Pharmacokinetics

Pefloxacin is a fluoroquinolone antibiotic. Flouroquinolones such as pefloxacin possess excellent activity against gram-negative aerobic bacteria such as E.coli and Neisseria gonorrhoea as well as gram-positive bacteria including S. pneumoniae and Staphylococcus aureus. They also posses effective activity against shigella, salmonella, campylobacter, gonococcal organisms, and multi drug resistant pseudomonas and enterobacter.

Metabolism

Hepatic. Primary metabolites are pefloxacin N-oxide and norfloxacin.