Spectrum: Local Antimicrobial Stewardship, for Billings Clinic

Moxifloxacin

Restricted
Restricted

C. diff Risk

High

Oral Bioavailability

Excellent

Approximate Cost

See Below

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

400mg IV/PO daily

General Information

Common Usage

Common Usage

  • Empyema/lung abscess

  • Pneumonia including CAP, HAP, aspiration

  • Some intra-abdominal infections

  • CNS infections

Cost Dollar

Cost

  • Nonformulary inpatient - not stocked

  • PO: $2-3/day

  • IV: $25/day

Drug Monitoring

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

Adverse Effects

  • QTc prolongation

  • Dysglycemia

  • Rash

  • Tendinopathy and rupture

  • GI upset

  • Weakness exacerbation in myasthenia gravis

  • CNS toxicity including confusion, psychosis

Major Interactions

Major Interactions

QTc prolongation - Increased risk with other agents that prolong QTc

Divalent cations including Ca, Mg - Decreased absorption

Warfarin - Increased INR

Rifampin - Decrease moxifloxacin levels

Additional Information

Additional Information

Nonformulary and not stocked.

Inpatient - therapeutic interchange to levofloxacin (+/- metronidazole if anaerobic coverage is needed)

Pharmacology

Pharmacology

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 12 hours

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Poor

No renal adjustment required