Infectious disease

Fluoroquinolones song

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Fluoroquinolones

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Fluoroquinolones inhibit DNA gyrase (topoisomerase II) in gram-negatives and topoisomerase IV in gram-positives, blocking bacterial DNA replication.
Ciprofloxacin is the drug of choice for anthrax (Bacillus anthracis) and is a first-line agent for Pseudomonas aeruginosa among oral antibiotics.
Respiratory fluoroquinolones (levofloxacin, moxifloxacin) cover atypicals, Streptococcus pneumoniae, and gram-negatives, making them preferred for community-acquired pneumonia when beta-lactams cannot be used.
Fluoroquinolones are contraindicated in children and pregnant women due to cartilage toxicity (arthropathy) demonstrated in animal models.
A black box warning exists for tendinitis and tendon rupture, most commonly the Achilles tendon, with risk increased in patients also taking corticosteroids or over age
Fluoroquinolones prolong the QT interval and should be avoided in patients with hypokalemia, hypomagnesemia, or concurrent QT-prolonging drugs.
Ciprofloxacin inhibits CYP1A2, raising levels of theophylline and warfarin — a classic drug interaction.
Antacids containing aluminum, magnesium, or calcium, as well as iron and zinc supplements, chelate fluoroquinolones and significantly reduce their oral bioavailability.
Fluoroquinolones are associated with peripheral neuropathy and CNS effects including seizures, particularly in patients with renal insufficiency due to drug accumulation.
Moxifloxacin has no reliable urinary excretion and should NOT be used for urinary tract infections, unlike ciprofloxacin or levofloxacin.