see also:

• antibiotics

• synthetic fluorinated analogues of nalidixic acid (see under urinary antiseptics)
• active against a variety of Gram -ves & +ves by inhib. of DNA gyrase
• activity includes Enterobacteriacaea, Pseudomonas, Neisseria, and at higher levels, Staph, Legionella, Chlamydia & some mycobacteria with anaerobes being less susceptible.
• uses:
  • urinary tract infections (UTIs) / cystitis
  • infectious diarrhoea (Shigella, Salmonella, toxigenic E.coli)
  • Helicobacter
  • pelvic inflammatory disease (PID)
  • soft tissue, bone & joint infections
  • meningococcal chemoprophylaxis
• eg. norfloxacin, ciprofloxacin, ofloxacin

• allergy and hypersensitivity reactions and Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), including in those with HS to nalidixic acid
• may cause tendonitis & tendon rupture, especially in older patients on corticosteroids, or in patients with prolonged Rx (> 1 month)
• prolonged QTc and torsades de pointes if at risk eg known QT prolongation, uncorrected hypokalaemia, drugs which prolong QTc
• pseudomembranous colitis
• superinfection
• eosinophilia
• abnormal LFTs, liver failure
• crystalluria in alkaline urine
• renal failure
• seizures
• hallucinations
• intracranial hypertension
• erythema nodosum
• pancytopenia
• see full PI