Moxifloxacin: Antibiotic for Bacterial Infections

Moxifloxacin is an antibiotic used primarily in the treatment of bacterial diseases of the respiratory tract. Moxifloxacin, like the antibiotics ciprofloxacin and levofloxacin, belongs to the group of drugs called fluoroquinolones, which are also known as gyrase inhibitors. Moxifloxacin can be taken orally in the form of tablets or applied locally to the conjunctiva of the eye in the form of eye drops. Gastrointestinal discomfort and dizziness, headache, and fatigue may be side effects.

What is moxifloxacin?

Moxifloxacin is an antibiotic that belongs to the fluoroquinolones group. In tablet form, it is present as a compound with hydrochloride, as moxifloxacin hydrochloride (moxifloxacin Hcl). Moxifloxacin is mainly used in the treatment of bacterial respiratory diseases such as bronchitis, pneumonia and sinusitis. It is a drug that is usually taken in the form of film-coated tablets for bacterial infections or applied directly to the conjunctiva in the form of drops locally for eye infections.

Trade names of various manufacturers

Moxifloxacin is marketed by several manufacturers and is thus available under different trade names. For example, moxifloxacin and its generics have the following names:

  • Avalox

  • Vigamox

  • Moxifloxacin AL
  • Moxifloxacin Aurobindo
  • Moxifloxacin Actavis

How does moxifloxacin work?

The drug interferes with the metabolism of bacteria. Moxifloxacin has a harmful effect on the DNA structure of bacteria via inhibition of the enzyme topoisomerase II, which is also called gyrase, thus hindering their growth, reproduction and survival. Moxifloxacin has a broad spectrum of activity, including on bacteria that can survive without oxygen. Because of this broad spectrum of action, moxifloxacin is sometimes used as a reserve antibiotic in dentistry, for example, in the treatment of periodontal disease.

Side effects of moxifloxacin

How dangerous is moxifloxacin? In general, moxifloxacin is well tolerated in adults. However, side effects may occur during treatment with the antibiotic. The following side effects are possible and known:

  • Headache
  • Drowsiness
  • Stomach and intestinal complaints such as nausea, vomiting, diarrhea and pain.
  • Skin rashes and dry skin
  • Itching
  • Cardiac arrhythmia
  • Changes in electrical conduction at the heart (QT time prolongation).
  • Limb and joint pain
  • Swelling and rupture of tendons and cartilage damage.
  • Lowering of the cramp threshold
  • Increase in liver enzymes in the blood

Caution: rare but dangerous side effects with fluoroquinolone antibiotics.

Taking antibiotics from the fluoroquinolone group – such as moxifloxacin – can in rare cases cause tendon ruptures, nerve pain, sensitivity disorders or psychiatric symptoms such as anxiety, hallucinations or depression. After only a few tablets, these sometimes serious side effects can occur. These adverse effects may occur within hours to weeks of using moxifloxacin. In addition, the aforementioned side effects may persist for months or even permanently after discontinuation of the antibiotic.

BfArM restricts use of moxifloxacin

Because of these significant side effects, the German Federal Institute for Drugs and Medical Devices (BfArM) has restricted the indication for moxifloxacin on the recommendation of the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA).As part of a risk assessment procedure, the BfArM decided in 2008 to restrict the use of moxifloxacin in three of the four previously approved indications. Thus, moxifloxacin is to be prescribed for the oral treatment of acute bacterial sinusitis, acute exacerbation of chronic bronchitis caused by bacteria, and community-acquired pneumonia only if other antibiotics are unsuitable or ineffective. In a so-called red-hand letter of April 2019, the BfArM confirmed the possibility of serious and long-lasting side effects of moxifloxacin and other systemically and inhalatively applied quinolone as well as fluoroquinolone antibiotics.Accordingly, prescribing should be done only after a careful risk-benefit assessment.

Risk of aortic aneurysms and dissections.

According to studies, patients treated systemically or by inhalation with fluoroquinolones have about a twofold higher risk of aortic aneurysms and dissections compared with patients not taking antibiotics or taking other antibiotics. This is especially true for older individuals. Therefore, patients at risk for aortic aneurysms and dissections should take fluoroquinolones only after careful consideration and consideration of other treatment options. If you experience sudden pain in the abdomen, chest, or back, seek medical attention immediately.

Moxifloxacin drug interactions.

Moxifloxacin may cause damage to human liver cells and cardiac arrhythmias. It should therefore be taken only with caution together with other medications, which may also have a damaging effect on heart rhythm and the liver. Alcohol should also be avoided during treatment with moxifloxacin.

Contraindications: When should moxifloxacin not be used?

Moxifloxacin should be used with caution in cases of hypersensitivity to moxifloxacin hydrochloride or any other component of the medication. In addition, in people with a seizure disorder, it should be taken only after prior consultation with the treating physician, because moxifloxacin may promote the occurrence of seizures. In addition, the use of the drug is not recommended in children under 18 years of age, pregnant women and nursing mothers.

Uses of moxifloxacin

What is moxifloxacin used for? Moxifloxacin is available as tablets, infusion solution, and eye drops. Common uses include therapy for respiratory tract infections and conjunctivitis.

When does moxifloxacin start working and how quickly?

Because moxifloxacin kills bacteria while preventing them from reproducing, infection symptoms should decrease relatively quickly when the antibiotic is taken. The onset of action of moxifloxacin should therefore be evident after only a few days if there is a good response. However, the response is very individual – while some sufferers notice significant symptom relief after just one to three days, this takes much longer for others.

Moxifloxacin – when and how often to take?

The drug should be taken once a day, unchewed with plenty of liquid and always at the same time of day, if prescribed by the attending physician. There are usually no other special considerations when taking moxifloxacin film-coated tablets. The drug can also be taken separately from meals. No interactions have also been described with milk and other dairy products.

Dosage of moxifloxacin

When dosing moxifloxacin, the following instructions should be followed:

  • The usual dosage in adults is one film-coated tablet of 400 milligrams of moxifloxacin per day as a single dose.
  • The drug is approved only for adults 18 years and older, use in children is not recommended.
  • No dose adjustment is described in patients with impaired renal function (mild to moderate renal insufficiency), but use is not recommended in patients on dialysis.

How long does one take moxifloxacin?

How long and how often to apply or take moxifloxacin depends on the condition. Respiratory infections are usually treated for five to ten days, while pelvic and skin infections are usually treated for up to two or three weeks.

How long does moxifloxacin last?

Moxifloxacin can only work as long as there is enough active ingredient in the blood and tissues. Therefore, treatment with moxifloxacin should usually be continued for an additional two to three days after symptoms have subsided.

How long does moxifloxacin stay in the body?

The half-life of moxifloxacin is twelve hours. Eye drops usually do not accumulate as much in the body and act primarily locally. Nevertheless, in pregnant women, children, and those with seizure disorders or severe kidney disease, moxifloxacin should only be used in consultation with the treating physician.

Moxifloxacin: when to stop.

When side effects occur or in case of pregnancy, moxifloxacin should be discontinued.Discontinuation should be done only after consultation with the treating physician to evaluate possible alternative therapies, such as the antibiotic cefuroxime.

How much does moxifloxacin cost?

Moxifloxacin requires a prescription and is available only in pharmacies. The price varies by manufacturer and package size and should be asked at the pharmacy. For people with statutory health insurance, the drug is either co-payment-free or the co-payment is about five euros per pack.