Lomefloxacin is a fluoroquinolone antibiotic used to treat chronic bronchitis, as well as complicated and uncomplicated urinary tract infections. It is also used as a prophylactic or preventative treatment to prevent urinary tract infections in patients undergoing transrectal or transurethral surgical procedures.
Fluoroquinolone; Antibacterial
Lomefloxacin, a difluorinated quinolone derivative, is a bacterial gyrase inhibitor, effective against gram positive and gram negative bacteria. The acute toxicity of Lomefloxacin following systemic and topical ophthalmic application is low. Lomefloxacin interferes with bacterial DNA related processes like initiation, elongation, and termination phases of replication, transcription, DNA repairing, recombination, transposition, supercoiling and relaxation of DNA. The target molecule for quinolones is the A-subunit of bacterial enzyme gyrase (topoisomerase II). The forming of a stable complex between the quinolone and the whole gyrase teramer A2B2 leads to impaired enzyme functions, resulting in a rapid killing of sensitive bacteria.
Cross-resistance has only been reported with other quinolones, but not with any other group of antibiotics. No clinical studies are available about the efficacy in cases of infections with chlamydia.
ORAL Prophylaxis of surgical infections: Adult: 400 mg as a single dose 1-6 hr before procedure. Uncomplicated urinary tract infections: Adult: 400 mg once day. Due to E. coli: For 3 successive days. Due to K. pneumoniae, R mirabilis or S. saprophyticus: For 10 successive days. Complicated urinary tract infections: Adult: Due to E. coli, K. pneumoniae, P mirabilis or P aeruginosa: 400 mg once daily for 14 successive days. OPHTHALMIC Bacterial conjunctivitis: Adult: Instil 0.3% soin into the affected eye/s. OTIC/AURAL Otitis externa; Otitis media: Adult: Instil 0.3% soln into the affected ear/s.
In order to avoid reduction of efficacy, no ophthalmic preparations containing heavy metals, such as zinc, should be used during 15 minutes preceding and following application of Lomefloxacin. Bacteriostatic ophthalmic antibiotics should not be used concomitantly with Lomefloxacin eye drops.
Hypersensitivity to the drug or other quinolones: child <18 yr; pregnancy & lactation. Avoid prolonged exposure to sunlight or artificial UV light. Known or suspected CNS disorders e.g. severe cerebral arteriosclerosis, epilepsy or other factors that predispose to seizures. Avoid in patients w/ known QT prolongation, uncorrected hypokalaemia. May impair ability to drive or operate machinery. Renal impairment.
Nausea, abdominal pain or discomfort, diarrhoea; headache, dizziness, insomnia; rash, pruritus, photosensitivity; thrombocytopenia. Anaphylactic or anaphylactoid reactions.
Lomefloxacin should only be given during pregnancy when benefit outweighs risk. It is not known whether lomefloxacin is excreted in human milk. Other fluoroquinolones are excreted into human milk and lomefloxacin is excreted into rat milk. Quinolone-induced cartilage erosion and arthropathies that have been observed in juvenile animals render some concern over its possible toxic effects on the developing joints of nursing infants. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Practically there is no risk of adverse effects due to accidental oral ingestion, since a bottle of 5 ml eye drop solution contains only 15 mg Lomefloxacin. This corresponds to 3.75% of the recommended oral daily dose for adults of 400 mg Lomefloxacin.
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