Definition
ChEBI: A quinolone that is 4-oxo-1,4-dihydroquinoline which is substituted at positions 1, 3, 6 and 7 by ethyl, carboxy, fluorine, and 4-methylpiperazin-1-yl groups, respectively.
Pharmaceutical Applications
A 6-fluoro, 7-piperazinyl quinoline available for oral and intravenous administration. The in-vitro activity is very similar to that of norfloxacin . It is active against H. ducreyi, V. cholerae and Legionella spp., but Campylobacter and Acinetobacter spp. and pseudomonads are not susceptible. It has poor activity against pneumococci, chlamydiae, mycoplasmas and ureaplasmas. L. monocytogenes, Nocardia spp. and anaerobes are resistant.
A plasma concentration of c. 5 mg/L is achieved 1–1.5 h after a 400 mg oral dose. The plasma elimination half-life is 8.5–15 h. It is widely distributed, concentrations in bone, brain, blister fluid, CSF, saliva, sputum and prostate all approximating, and in some cases exceeding, the simultaneous plasma concentration. It is extensively metabolized to the desmethyl (= norfloxacin) and N-oxide derivatives. Some 60–70% of a dose, only about 10% of which is unchanged, appears in the urine; 25% of a dose appears in the feces, a small part contributed by elimination in the bile.
The half-life increases with hepatic impairment, but is virtually unaffected by renal failure. In patients on continuous ambulatory peritoneal dialysis (CAPD) given 800 mg followed by 400 mg every 12 h for 10–12 days, there was no significant accumulation of pefloxacin or its metabolite, norfloxacin, but concentrations of pefloxacin N-oxide rose continuously in plasma and dialysate; all concentrations fell rapidly when treatment was discontinued.
Adverse reactions are those common to the group . Most common are gastrointestinal tract disturbances, although some typical CNS reactions have been encountered. Skin eruptions (some photosensitive) occur and rashes appeared in about one-third of a group of patients who were given longterm therapy. Clinical uses are similar to those of ofloxacin.
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