Moxifloxacin combinations

Jung R, et al. Synergistic activities of moxifloxacin combined with piperacil-lin-tazobactam or cefepime against Klebsiella pneumoniae, Enterobacter cloacae, and Acinetobacter baumannii clinical isolates. Antimicrob. Agents Chemother., 2004, 48, 1055-1057. 

Ciprofloxacin, levofloxacin, moxifloxacin, or gati-floxacin in combination with metronidazole... 

The quinoline antibiotics are relatively late arrivals on the antibiotic scene. The parent compound of this class of drugs is nalidixic acid. The downside of this molecule is the rapid development of resistance by pathogenic bacteria. A major step forward was the introduction of a single fluorine atom at a key position, to yield new molecules such as ciprofloxacin, ofloxacin, levofloxacin, andmoxifloxacin. Of these, levofloxacin and moxifloxacin have the best combinations of spectrum of action, potency, and pharmacokinetic properties. In time, they are likely to largely replace the current quinoline antibiotic of choice, ciprofloxacin. Since these molecules work by a different mechanism than do the p-lactams, organisms that become resistant to the latter are generally susceptible to the former. 

Gillespie SH et al Early bactericidal activity of a moxifloxacin and isoniazid combination in smear-positive pulmonary tuberculosis. J Antimicrob Chemother 2005 56 1169. [PMID 16223939]... 

H. parainfluenzae (MIC, 0.03-0.25 mg I. ) [150], M. catarrhalis (MIC90 0.03-0.125 mg L"1) [149,151,182] and K. pneumoniae [33,182,187,188], although its activity against specific bacteria is less powerful than that of ciprofloxacin [188]. When moxifloxacin was used in combination with cefepime or piperacilhn/tazobactam against clinical isolates of K. pneumoniae, Enterobacter cloacae and Acinetobacter baumannii, an increase in bactericidal activity was obtained compared to that of the individual compounds this was due to synergistic effects between the different compounds [189]. 

Moxifloxacin s MIC90 value of 1 mg L"1 means that it has the same in vitro activity against M. tuberculosis as levofloxacin, and is more effective than ofloxacin (MIC90 = 2 mg L"1) and ciprofloxacin (MIC90 = 4 mg IT1) [192-194]. A combination of moxifloxacin and isoniazid proved to be more effective in vivo than the individual compounds [195,196], whereas a combination with ethambutol was less effective [196]. Based on the mutant prevention concentration (MPC), which is a parameter for the selection of resistant pathogens during antibiotic treatment, moxifloxacin was found to be the most effective fluoroquinolone against M. tuberculosis [197]. 

In animal experiments, moxifloxacin is highly active against M. leprae, in particular in combination with rifapentine/minocycline [206]. 

There was no clinically relevant effect of moxifloxacin on the pharmacokinetics of digoxin in combination steady-state conditions (4). 

A 76-year-old man with low-risk myelodysplastic sjm-drome had a major erythroid response to combination therapy with epoetin and moxifloxacin (27). The immunomodulatory effects of moxifloxacin may have explained the synergy with epoetin. 

When there is neither growth in blood/tip cultures nor previously documented infection, we administer an empiric combination of different antibiotical class against the most common pathogenic agents (e.g. Moxifloxacin and Rifampicin) based on the usual antibiotic sensitivity in positive tip cultures. Blood tests are repeated at 1, 2, and 4 weeks, including inflammatory response indicators. Follow-up is necessary to document recovery from the infection and particularly regression of endocarditis lesions. 

Mycobacterium tuberculosis (extensively drug-resistant) Lung Drug combinations (strepto-mycin/isonicotinyl/ hydrazine/rifampin/ ethambutol/pyrazinamide/ moxifloxacine/cycloser-ine/imipenem/co-amoxi-clav/clofazimine/ prochlorperazine/ metronidazole), PA-824 and R207910... 

Kern WV, Marchetti O, Drgona L, Akan H, Aoun M, Akova M, et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer a double-blind, randomized, multicenter trial comparing single daily moxifloxacin with twice daily ciprofloxacin plus amoxiciUin/clavulanic acid combination therapy-EORTC infectious diseases group trial XV. J Clin Oncol 2013 31(9) 1149-56. 

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