Pefloxacin

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A fluoroquinolone antibiotic


Pefloxacin
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Pefloxacin is a fluoroquinolone antibiotic used to treat a variety of bacterial infections. It is a synthetic chemotherapeutic agent that is effective against a broad spectrum of Gram-positive and Gram-negative bacteria. Pefloxacin is particularly used in the treatment of urinary tract infections, respiratory tract infections, and gastrointestinal infections.

Pharmacology

Pefloxacin works by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes critical for DNA replication and transcription. This inhibition leads to the disruption of bacterial cell division and ultimately results in bacterial cell death. The drug is bactericidal, meaning it kills bacteria rather than merely inhibiting their growth.

Administration and Dosage

Pefloxacin is typically administered orally in the form of tablets, but it can also be given intravenously in more severe cases. The dosage of pefloxacin depends on the type and severity of the infection, as well as the patient's renal function. It is important for patients to complete the full course of the antibiotic to prevent the development of antibiotic resistance.

Side Effects

Common side effects of pefloxacin include nausea, vomiting, diarrhea, and abdominal pain. Some patients may experience central nervous system effects such as headache, dizziness, and insomnia. Rare but serious side effects include tendonitis and tendon rupture, particularly in older adults and those on concurrent corticosteroid therapy.

Contraindications

Pefloxacin is contraindicated in patients with a known hypersensitivity to quinolones. It should be used with caution in patients with a history of seizures or other central nervous system disorders. The use of pefloxacin in pregnancy and breastfeeding is generally not recommended unless the potential benefits outweigh the risks.

Mechanism of Resistance

Bacterial resistance to pefloxacin can occur through several mechanisms, including mutations in the genes encoding DNA gyrase and topoisomerase IV, as well as efflux pumps that expel the drug from bacterial cells. The development of resistance is a significant concern and underscores the importance of appropriate antibiotic use.

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Contributors: Prab R. Tumpati, MD