Developer site: The content shown here is test data.

Health Dictionary AI Health Chat Find an Online Doctor
A serene Zen garden with raked sand and smooth stones, symbolising clarity and calm

Health Dictionary

Back to skin conditions

Enoxacin

Introduction

Overview

Overview

Enoxacin is an oral broad-spectrum fluoroquinolone antibacterial agent used in the treatment of urinary tract infections and gonorrhea. Insomnia is a common adverse effect.[1][2] It is no longer available in the United States.

It has been shown recently that it may have cancer inhibiting effect.

Mechanism of action

Mechanism of action

Quinolones and fluoroquinolones are bactericidal drugs, eradicating bacteria by interfering with DNA replication. Like other fluoroquinolones, enoxacin functions by inhibiting bacterial DNA gyrase and topoisomerase IV. The inhibition of these enzymes prevents bacterial DNA replication, transcription, repair and recombination.[3][4] Enoxacin is active against many Gram-positive bacteria.[note 1] The quinolone is also active against Gram-negative bacteria[note 2][5][6]

Pharmacokinetics

Pharmacokinetics

After oral administration enoxacin is rapidly and well absorbed from the gastrointestinal tract. The antibiotic is widely distributed throughout the body and in the different biological tissues. Tissue concentrations often exceed serum concentrations. The binding of enoxacin to serum proteins is 35 to 40%. The serum elimination half-life, in subjects with normal renal function, is approximately 6 hours. Approximately 60% of an orally administered dose is excreted in the urine as unchanged drug within 24 hours.[7][8] A small amount of a dose of drug administered is excreted in the bile.[9] High concentrations of the fluoroquinolone are reached in the urinary tract and this fact ensures an antibacterial effect continued over time, particularly in this district.

Medical uses

Medical uses

Enoxacin can be used to treat a wide variety of infections, particularly gastroenteritis including infectious diarrhea, respiratory tract infections, gonorrhea[10] and urinary tract infections.[11][12]

Adverse effects

Adverse effects

Enoxacin, like other fluoroquinolones, is known to trigger seizures or lower the seizure threshold.[13] The compound should not be administered to patients with epilepsy or a personal history of previous convulsive attacks as may promote the onset of these disorders.[14]

Contraindications

Contraindications

Enoxacin is contraindicated in subjects with a history of hypersensitivity to the substance or any other member of the quinolone class, or any component of the medicine. Enoxacin, like other fluoroquinolones, can cause degenerative changes in weightbearing joints of young animals. The compound should only be used in children when the expected benefits are outweigh the risks.[15][16]

Interactions

Interactions

  • Fenbufen: co-administration with some quinolones, including enoxacin may increase the risk of seizures. For this reason, concomitant administration of fenbufen and the quinolone should be avoided, as a precaution.[17][18][19][20]
  • Theophylline: in patients treated concurrently with theophylline and enoxacin, concentrations of the methylxanthine in plasma arise due to a reduced metabolic clearance of theophylline.[21][22][23][24]
  • Ranitidine, sucralfate, antacids containing magnesium or aluminum, supplements containing calcium, iron, or zinc: co-administration with these substances can lead to therapeutic failure of the antibiotic due to decreased absorbment by the intestinal tract. For example magnesium or aluminum antacids turn enoxacin into insoluble salts that are not readily absorbed by the gastroenteric tract.[25][26][27]
References

References

  1. ↑ Rafalsky, V.; Andreeva, I.; Rjabkova, E.; Rafalsky, Vladimir V (2006). Rafalsky, Vladimir V, ed. “Quinolones for uncomplicated acute cystitis in women”. Cochrane Database Syst Rev. 3 (3): CD003597. doi:10.1002/14651858.CD003597.pub2. PMIDΒ 16856014.
  2. ↑ Mogabgab, WJ. (Dec 1991). “Recent developments in the treatment of sexually transmitted diseases”. Am J Med. 91 (6A): 140S–144S. doi:10.1016/0002-9343(91)90327-T. PMIDΒ 1767802.
  3. ↑ Yoshida H, Nakamura M, Bogaki M, Ito H, Kojima T, Hattori H, Nakamura S (April 1993). “Mechanism of action of quinolones against Escherichia coli DNA gyrase”. Antimicrob. Agents Chemother. 37 (4): 839–45. doi:10.1128/aac.37.4.839. PMCΒ 187778. PMIDΒ 8388200. Retrieved 2014-09-24.
  4. ↑ Wolfson JS, Hooper DC (October 1985). “The fluoroquinolones: structures, mechanisms of action and resistance, and spectra of activity in vitro”. Antimicrob. Agents Chemother. 28 (4): 581–6. doi:10.1128/aac.28.4.581. PMCΒ 180310. PMIDΒ 3000292. Retrieved 2014-09-24.
  5. ↑ Chin NX, Neu HC (November 1983). “In vitro activity of enoxacin, a quinolone carboxylic acid, compared with those of norfloxacin, new beta-lactams, aminoglycosides, and trimethoprim”. Antimicrob. Agents Chemother. 24 (5): 754–63. doi:10.1128/aac.24.5.754. PMCΒ 185938. PMIDΒ 6229216. Retrieved 2014-09-24.
  6. ↑ Wise R, Andrews JM, Danks G (March 1984). “In-vitro activity of enoxacin (CL-919), a new quinoline derivative, compared with that of other antimicrobial agents”. J. Antimicrob. Chemother. 13 (3): 237–44. doi:10.1093/jac/13.3.237. PMIDΒ 6586712. Retrieved 2014-09-24.
  7. ↑ Wise R, Lockley R, Dent J, Webberly M (July 1984). “Pharmacokinetics and tissue penetration of enoxacin”. Antimicrob. Agents Chemother. 26 (1): 17–9. doi:10.1128/aac.26.1.17. PMCΒ 179907. PMIDΒ 6591851. Retrieved 2014-09-24.
  8. ↑ Wise R, Lister D, McNulty CA, Griggs D, Andrews JM (1986). “The comparative pharmacokinetics and tissue penetration of four quinolones including intravenously administered enoxacin”. Infection. 14 Suppl 3: S196–202. doi:10.1007/bf01667843. PMIDΒ 3463542. |access-date= requires |url= (help)
  9. ↑ Flowerdew, A., E. Walker, and S. J. Karran. “Evaluation of biliary pharmacokinetics of oral enoxacin, a new quinolone antibiotic.” 14th International Congress of Chemotherapy, Kyoto. 1985.
  10. ↑ van der Willigen AH, van der Hoek JC, Wagenvoort JH, van Vliet HJ, van Klingeren B, Schalla WO, Knapp JS, van Joost T, Michel MF, Stolz E (April 1987). “Comparative double-blind study of 200- and 400-mg enoxacin given orally in the treatment of acute uncomplicated urethral gonorrhea in males”. Antimicrob. Agents Chemother. 31 (4): 535–8. doi:10.1128/aac.31.4.535. PMCΒ 174773. PMIDΒ 3111354. Retrieved 2014-09-24.
  11. ↑ Huttunen M, Kunnas K, Saloranta P (February 1988). “Enoxacin treatment of urinary tract infections in elderly patients”. J. Antimicrob. Chemother. 21 Suppl B: 105–11. doi:10.1093/jac/21.suppl_b.105. PMIDΒ 3162900. Retrieved 2014-09-24.
  12. ↑ Backhouse CI, Matthews JA (June 1989). “Single-dose enoxacin compared with 3-day treatment for urinary tract infection”. Antimicrob. Agents Chemother. 33 (6): 877–80. doi:10.1128/aac.33.6.877. PMCΒ 284249. PMIDΒ 2764538. Retrieved 2014-09-24.
  13. ↑ De Sarro A, ZappalΓ‘ M, Chimirri A, Grasso S, De Sarro GB (July 1993). “Quinolones potentiate cefazolin-induced seizures in DBA/2 mice”. Antimicrob. Agents Chemother. 37 (7): 1497–503. doi:10.1128/aac.37.7.1497. PMCΒ 188001. PMIDΒ 8395790. Retrieved 2014-09-25.
  14. ↑ Simpson KJ, Brodie MJ (July 1985). “Convulsions related to enoxacin”. Lancet. 2 (8447): 161. PMIDΒ 2862357. |access-date= requires |url= (help)
  15. ↑ Chalumeau M, Tonnelier S, D’Athis P, TrΓ©luyer JM, Gendrel D, BrΓ©art G, Pons G (June 2003). “Fluoroquinolone safety in pediatric patients: a prospective, multicenter, comparative cohort study in France”. Pediatrics. 111 (6 Pt 1): e714–9. doi:10.1542/peds.111.6.e714. PMIDΒ 12777590. Retrieved 2014-09-24.
  16. ↑ “The use of systemic fluoroquinolones”. Pediatrics. 118 (3): 1287–92. September 2006. doi:10.1542/peds.2006-1722. PMIDΒ 16951028. Retrieved 2014-09-24.
  17. ↑ Morita H, Maemura K, Sakai Y, Kaneda Y (May 1988). “[A case of convulsion, loss of consciousness and subsequent acute renal failure caused by enoxacin and fenbufen]”. Nippon Naika Gakkai Zasshi (in Japanese). 77 (5): 744–5. doi:10.2169/naika.77.744. PMIDΒ 3216153. |access-date= requires |url= (help)
  18. ↑ Hara Y, Ally A, Suzuki T, Murayama S (October 1992). “[Effects of drugs on the convulsions induced by the combination of a new quinolone antimicrobial, enoxacin, and a nonsteroidal anti-inflammatory drug, fenbufen, in mice]”. Nippon Yakurigaku Zasshi (in Japanese). 100 (4): 301–5. doi:10.1254/fpj.100.301. PMIDΒ 1446880. |access-date= requires |url= (help)
  19. ↑ Masukawa T, Nakanishi K, Natsuki R (April 1998). “Role of nitric oxide in the convulsions following the coadministration of enoxacin with fenbufen in mice”. Jpn. J. Pharmacol. 76 (4): 425–9. doi:10.1254/jjp.76.425. PMIDΒ 9623721. Retrieved 2014-09-25.
  20. ↑ Masukawa T, Nakanishi K (February 1997). “Circadian variation in enoxacin-induced convulsions in mice coadministered with fenbufen”. Jpn. J. Pharmacol. 73 (2): 175–7. doi:10.1254/jjp.73.175. PMIDΒ 9074952. Retrieved 2014-09-25.
  21. ↑ Wijnands WJ, van Herwaarden CL, Vree TB (July 1984). “Enoxacin raises plasma theophylline concentrations”. Lancet. 2 (8394): 108–9. PMIDΒ 6145999. |access-date= requires |url= (help)
  22. ↑ Niki Y, Soejima R, Kawane H, Sumi M, Umeki S (October 1987). “New synthetic quinolone antibacterial agents and serum concentration of theophylline”. Chest. 92 (4): 663–9. doi:10.1378/chest.92.4.663. PMIDΒ 3477409. Retrieved 2014-09-25.
  23. ↑ Mizuki Y, Fujiwara I, Yamaguchi T, Sekine Y (August 1996). “Structure-related inhibitory effect of antimicrobial enoxacin and derivatives on theophylline metabolism by rat liver microsomes”. Antimicrob. Agents Chemother. 40 (8): 1875–80. PMCΒ 163433. PMIDΒ 8843297. Retrieved 2014-09-25.
  24. ↑ Sano M, Kawakatsu K, Ohkita C, Yamamoto I, Takeyama M, Yamashina H, Goto M (1988). “Effects of enoxacin, ofloxacin and norfloxacin on theophylline disposition in humans”. Eur. J. Clin. Pharmacol. 35 (2): 161–5. doi:10.1007/bf00609246. PMIDΒ 3191935. |access-date= requires |url= (help)
  25. ↑ Grasela TH, Schentag JJ, Sedman AJ, Wilton JH, Thomas DJ, Schultz RW, Lebsack ME, Kinkel AW (May 1989). “Inhibition of enoxacin absorption by antacids or ranitidine”. Antimicrob. Agents Chemother. 33 (5): 615–7. doi:10.1128/aac.33.5.615. PMCΒ 172500. PMIDΒ 2751276. Retrieved 2014-09-25.
  26. ↑ Nix DE, Lebsack ME, Chapelsky M, Sedman AJ, Busch J, Norman A (April 1993). “Effect of oral antacids on disposition of intravenous enoxacin”. Antimicrob. Agents Chemother. 37 (4): 775–7. doi:10.1128/aac.37.4.775. PMCΒ 187758. PMIDΒ 8494374. Retrieved 2014-09-25.
  27. ↑ Misiak PM, Eldon MA, Toothaker RD, Sedman AJ (January 1993). “Effects of oral cimetidine or ranitidine on the pharmacokinetics of intravenous enoxacin”. J Clin Pharmacol. 33 (1): 53–6. doi:10.1002/j.1552-4604.1993.tb03903.x. PMIDΒ 8429114. Retrieved 2014-09-25.

Template:QuinoloneAntiBiotics
<ref> tags exist for a group named “note”, but no corresponding <references group="note"/> tag was found

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]