Enoxacin is a medical agent that is widely used as a synthetic antibiotic. It is used in medications to treat infections caused by enoxacin-susceptible bacteria. These include acute and moderate urinary tract infections, gonorrhea, and skin and respiratory tract infections.
What is enoxacin?
Enoxacin is a synthetically produced antibiotic. Due to its chemical or pharmacological properties as well as its mode of action, the substance is assigned to the group of fluoroquinolones. The active substances norfloxacin and ofloxacin are also part of this group. Enoxacin is one of the more modern representatives of this group. Accordingly, the drug has a particularly high efficacy, which is reflected in a wide range of applications. For example, enoxacin can be used to treat gram-negative bacteria in particular, which is not the case with all fluoroquinolones. Gram-negative bacteria are all infectious bacteria that turn red when a differential staining procedure is performed. They are distinguished by this staining from gram-positive pathogens, which turn blue in the course of differential staining. The effect of enoxacin is bactericidal. The antibiotic kills bacteria specifically by inhibiting their enzyme gyrase. Enoxacin is therefore also categorized as a gyrase inhibitor. The white to whitish-yellow substance is described in chemistry by the molecular formula C 15 – H 17 – F – N 4 – O 3 and has a moral mass of 320.32 g/mol. It is usually ingested orally.
Pharmacological action
Enoxacin has a bactericidal effect. Thus, the drug specifically kills infectious bacteria. This is made possible by inhibiting the bacteria’s own enzyme, gyrase. This enzyme is of immense importance for the cell, as it controls, among other things, DNA supercoiling (spatial arrangement of DNA through the formation of ring-shaped molecules). After gyrase is inhibited, infectious bacteria are no longer able to multiply. They die. Although enoxacin is generally considered to be quite effective and has a broad spectrum of activity, it cannot be used against all bacteria. Its efficacy is particularly low against bacteria of the supercategory cocci, which include the well-known pathogens streptococci, pneumococci and staphylococci. In addition, enoxacin has become less important in recent years because new representatives of the same class of active ingredients (e.g., levofloxacin or ciprofloxacin) have a more intense pharmacological effect. Compared with enoxacin, these have a lower interaction potential and a stronger bactericidal effect. Enoxacin is taken orally and marketed in the form of film-coated tablets. Preparations containing the active ingredient are available by prescription only.
Medical use and application
Enoxacin is used for infections caused by enoxacin-susceptible bacteria. These include some gram-negative bacteria. Medical indications for enoxacin include infections of the urinary tract, kidneys, or prostate. In addition, enoxacin is prescribed for gonorrhea (colloquially known as “gonorrhea”). It is also used for bacterial infections of the upper and lower respiratory tract, including the ear, nose and throat. Due to only low effectiveness, there is no indication in such infections, which are due to pneumococci, streptococci or staphylococci. Since most pneumonia acquired outside of hospitals is caused by pneumococci, there is usually no prescription for enoxacin in these cases. However, enoxacin is used without restriction for skin infections or skin appendages. The dosage of preparations containing enoxacin varies depending on the disease to be controlled. In most cases, however, two to four tablets are taken daily and prescribed for a period of seven to 14 days. To be easy on the stomach, it should be taken with or shortly after a meal.
Risks and side effects
Enoxacin should not be administered if there is hypersensitivity to the active ingredient. The drug must also not be taken if there are allergies to other members of the fluoroquinolone group (e.g., norfloxacin, levofloxacin, ciprofloxacin, or ofloxacin) for safety reasons.A contraindication (medical contraindication) also exists in children and adolescents in the growth phase. In this group, there is insufficient evidence regarding the safety of use. A contraindication also exists in epileptics and patients with a creatinine clearance of less than 30 ml/min. Undesirable side effects may occur during treatment with enoxacin. Their statistical distribution is as follows:
- Loss of appetite and diarrhea, elevation of liver enzymes, and skin reactions (e.g., mild rashes) occur very frequently (in more than one in 10 people treated).
- Frequently (in more than one in 100 treated), stomach discomfort, vomiting, and nausea occur. However, an increase in serum creatinine levels and anaphylactic reactions are also possible after enoxacin administration.
- Occasionally (in more than one in 1,000 people treated), anemia may develop. Visual and taste disturbances and abdominal pain are also conceivable.
- Rarely (in more than one in 10,000 treated but less than one in 1,000), severe skin reactions (e.g., Stevens-Johnson syndrome or Lyell syndrome) occur. Also rare are agitation and photophobia.
- Very rarely (in less than one in 10,000 treated), drowsiness, seizures, and hyperglycemia.
