Moxifloxacin

Moxifloxacin, sold under the brandname Avelox among others, is an antibiotic used to treat a number of bacterial infections. This includes pneumonia, conjunctivitis, endocarditis, tuberculosis, and sinusitis. It is used by mouth, by injection into a vein, or as an eye drop. Common side effects include diarrhea, dizziness, and headache. Severe side effects may include spontaneous tendon ruptures, nerve damage, and worsening of myasthenia gravis. Safety of use in pregnancy or breastfeeding is unclear. Moxifloxacin is in the fluoroquinolone family of medications. It usually results in bacterial death through blocking their ability to duplicate DNA. Moxifloxacin was patented in 1988 and approved for use in the United States in 1999. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is US$0.45–2.70 per day, as of 2015. In the United States, as of 2017, the wholesale cost is about $4.00 per day. Moxifloxacin is used to treat a number of infections, including: respiratory tract infections, cellulitis, anthrax, intra-abdominal infections, endocarditis, meningitis, and tuberculosis. In the United States, moxifloxacin is licensed for the treatment of acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, community acquired pneumonia, complicated and uncomplicated skin and skin structure infections, and complicated intra-abdominal infections. In the European Union, it is licensed for acute bacterial exacerbations of chronic bronchitis, non-severe community-acquired pneumonia, and acute bacterial sinusitis. Based on its investigation into reports of rare but severe cases of liver toxicity and skin reactions, the European Medicines Agency recommended in 2008 that the use of the by mouth (but not the IV) form of moxifloxacin be restricted to infections in which other antibacterial agents cannot be used or have failed. In the US, the marketing approval does not contain these restrictions, though the label contains prominent warnings against skin reactions. The initial approval by the FDA (December 1999) encompassed these indications: