1: Drug Saf. 2009;32(5):359-78. doi: 10.2165/00002018-200932050-00001.

Safety profile of the respiratory fluoroquinolone moxifloxacin: comparison with
other fluoroquinolones and other antibacterial classes.

Van Bambeke F, Tulkens PM.

Unité de pharmacologie cellulaire et moléculaire & Centre de Pharmacie Clinique, 
Louvain Drug Research Institute, Université catholique de Louvain, Brussels,

Moxifloxacin, a fluoroquinolone with potent activity against respiratory
pathogens, is approved and considered as an alternative to beta-lactams and
macrolides for the treatment of acute bacterial sinusitis and lower respiratory
tract infections. In this review, we critically examine its safety profile in
comparison with other fluoroquinolones and other antibacterial classes sharing
similar indications. Data were extracted from published clinical trials,
meta-analyses, postmarketing studies, spontaneous report systems and case reports
for rare effects. Global analysis did not reveal significantly higher incidences 
of drug-related adverse effects than for comparators. Tendon rupture was
infrequent with moxifloxacin, including when used in elderly patients with
chronic obstructive pulmonary disease. Severe toxic cutaneous reactions and
allergies were very rare. Phototoxicity and CNS adverse effects were less common 
than with other fluoroquinolones. Although causing a 4-7 msec corrected QT
interval prolongation, severe cardiac toxicity was neither seen in large cohorts 
or clinical trials nor reported to pharmacovigilance systems. Hepatotoxicity was 
not different from what was observed for other fluoroquinolones (excluding
trovafloxacin) and less frequent than reported for amoxicillin-clavulanic acid or
telithromycin. The data show that using moxifloxacin, in its accepted indications
and following the corresponding guidelines, should not be associated with an
excessive incidence of drug-related adverse reactions, provided the clinician
takes care in identifying patients with known risk factors and pays due attention
to the contraindications and warnings mentioned in the labelling.

PMID: 19419232 [PubMed - in process]

Related Links

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