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MAXAQUIN (LOMEFLOXACIN HYDROCHLORIDE) TABLETS: INDICATIONS AND USAGE
Maxaquin (Lomefloxacin HCl) film-coated tablets are indicated for the treatment of adults with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below.
Lower respiratory tract
Acute bacterial exacerbation of chronic bronchitis caused by Haemophilus influenzae or Moraxella catarrhalis.
NOTE: Maxaquin is not indicated for the empiric treatment of acute bacterial exacerbation of chronic bronchitis when it is probable that s pneumoniae is a causative pathogen. S Pneumoniae exhibits in vitro resistance to lomefloxacin, and the safety and efficacy of Lomefloxacin in the treatment of patients with acute bacterial exacerbation of chronic bronchitis caused by s pneumoniae have not been demonstrated. If lomefloxacin is to be prescribed for gramstain-guided empiric therapy of acute bacterial exacerbation of chronic bronchitis, it should be used only if sputum gram stain demonstrates an adequate quality of
specimen ( > 25 PMNs/LPF) and there is both a predominance of Gram-negative microorganisms and not a predominance of Gram-positive microorganisms.
Uncomplicated urinary tract infections (cystitis) caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Staphylococcus saprophyticus.
Complicated urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Citrobacter diversus, or Enterobacter cloacae.
NOTE: In clinical trials with patients experiencing complicated urinary tract infections (UTIs) due to P aeruginosa, 12 of 16 patients had the microorganism eradicated from the urine after therapy with lomefloxacin. None of the patients had concomitant bacteremia. Serum levels of lomefloxacin do not reliably exceed the MIC of Pseudomonas isolates. The safety and efficacy of lomefloxacin in treating patients with pseudomonas bacteremia have not been established.
Although treatment of infections due to this microorganism in this organ system demonstrated a clinically acceptable overall outcome, efficacy was studied in fewer than 10 infections.
Appropriate culture and susceptibility tests should be performed before antimicrobial treatment in order to isolate and identify microorganisms causing infection and to determine their susceptibility to lomefloxacin. In patients with UTIs, therapy with Maxaquin film-coated tablets may be initiated before results of these tests are known; once these results become available, appropriate therapy should be continued. In patients with an acute bacterial exacerbation of chronic bronchitis, therapy should not be started empirically with lomefloxacin when there is a probability the causative pathogen is S pneumoniae.
Beta-lactamase production should have no effect on lomefloxacin activity.
Prevention / prophylaxis
Maxaquin (Lomefloxacin) tablets are indicated preoperatively for the prevention of infection in the following situations:
Transrectal prostate biopsy: to reduce the incidence of urinary tract infection, in the early and late postoperative periods (3.5 days and 3.4 weeks postsurgery).
Transurethral surgical procedures: to reduce the incidence of urinary tract infection in the early postoperative period (3.5 days postsurgery).
Efficacy in decreasing the incidence of infections other than urinary tract infection has not been established. Maxaquin, like all drugs for prophylaxis of transurethral surgical procedures, usually should not be used in minor urologic procedures for which prophylaxis is not indicated (eg, simple cystoscopy or retrograde pyelography).
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Maxaquin and other antibacterial drugs, Maxaquin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
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