15th March 2024

Quinolones/Fluoroquinolones

These agents inhibit nucleic acid synthesis by inhibiting DNA gyrase and topoisomerase IV. Examples include ciprofloxacin and levofloxacin. They have a broad spectrum of activity against gram-positive, gram-negative and mycobacteria.

There are several notable adverse effects including prolongation of the QT interval, CNS symptoms (headache, dizziness and insomnia), and worsening or unmasking myasthenia gravis. There is a risk of tendon rupture, especially in older people and those with renal impairment. It should not be used in those with a history of tendon disorders or young children. It is known to inhibit CYP1A and CYP3A, potentiating the effects of theophylline, ciclosporin and warfarin.