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DOSAGE
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Conjunctivitis: 1 gtt TID x 7 days
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Low risk of vision loss: 1 gtts q1-2hr + Optional add on tobramycin or ciprofloxacin ung qHS
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Moderate risk of vision loss: Loading dosage q5min for 5 doses, then q30min until midnight, then q1hr
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Vision-threatening: Consider fortified tobraymycin or gentamicin (15 mg/ml) q1hr, alternating with fortified cefazolin (50mg/ML) or vancomycin (25mg/mL) q1hr.
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INDICATIONS
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VIGAMOX® is indicated for the treatment of bacterial conjunctivitis, off label for corneal ulcer.
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MECHANISM OF ACTION
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fluoroquinolone (4th): Binds bacterial DNA gyrase topoisomerase II and topoisomerase IV
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MICROBIOLOGY
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Active against a very broad range of gram negative and positive organisms. Moxifloxacin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the Indications and Usage section: Aerobic Gram-Positive Microorganisms Corynebacterium species* Micrococcus luteus* Staphylococcus aureus Staphylococcus epidermidis Staphylococcus haemolyticus Staphylococcus hominis Staphylococcus warneri* Streptococcus pneumoniae Streptococcus viridans group Aerobic Gram-Negative Microorganisms Acinetobacter lwoffii* Haemophilus influenza Haemophilus parainfluenzae* Other Microorganisms Chlamydia trachomatis The following organisms are considered susceptible when evaluated using systemic breakpoints. However, a correlation between the in vitro systemic breakpoint and ophthalmological efficacy has not been established. The list of organisms is provided as guidance only in assessing the potential treatment of conjunctival infections. Moxifloxacin exhibits in vitro minimal inhibitory concentrations (MICs) of 2 microgram/mL or less (systemic susceptible breakpoint) against most (greater than or equal to 90%) strains of the following ocular pathogens. Aerobic Gram-Positive Microorganisms Listeria monocytogenes Staphylococcus saprophyticus Streptococcus agalactiae Streptococcus mitis Streptococcus pyogenes Streptococcus Group C, G, and F Aerobic Gram-Negative Microorganisms Acinetobacter baumannii Acinetobacter calcoaceticus Citrobacter freundii Citrobacter koseri Enterobacter aerogenes Enterobacter cloacae Escherichia coli Klebsiella oxytoca Klebsiella pneumoniae Moraxella catarrhalis Morganella morganii Neisseria gonorrhoeae Proteus mirabilis Proteus vulgaris Pseudomonas stutzeri Anaerobic Microorganisms Clostridium perfringens Fusobacterium species Prevotella species Propionibacterium acnes Other Microorganisms Chlamydia pneumoniae Legionella pneumophila Mycobacterium avium Mycobacterium marinum Mycoplasma pneumoniae
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CONTRAINDICATIONS & WARNINGS
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VIGAMOX is contraindicated in patients with a history of hypersensitivity to moxifloxacin, to other quinolones, or to any of the components in this medication.
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PEDIATRIC USE
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The safety and effectiveness have been established in all ages
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PREGNANCY
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Pregnancy category C | there are no adequate and well-controlled studies with VIGAMOX® in pregnant women to inform any drug-associated risks. Oral administration of moxifloxacin to pregnant rats and monkeys and intravenously to pregnant rabbits during the period of organogenesis did not produce adverse maternal or fetal effects at clinically relevant doses. Oral administration of moxifloxacin to pregnant rats during late gestation through lactation did not produce adverse maternal, fetal or neonatal effects at clinically relevant doses
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