Sparfloxacin

Indications

Sparfloxacin is used for: Chronic bronchitis, Community-acquired pneumonia

Adult Dose

Oral Adult 2 tablets (400 mg) on 1st day as a loading dose, followed by 1 tablet (200 mg) daily as a maintenance dose. Duration of maintenance treatment is 10 days.

Child Dose

Renal Dose

Renal impairment (Creatinine clearance < 50 ml/min) is 2 tablets (400 mg) taken on the first day as a loading dose. Thereafter, 1 tablet of 200 mg should be taken every 48 hours for total 9 days of therapy.

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity; pregnancy and lactation; children <18 yr.

Precautions

History of CNS disorders, pseudomembranous colitis, superinfection, severe renal dysfunction, epilepsy, G6PD deficiency, myasthenia gravis, patients with QT prolongation, uncorrected electrolyte disturbances, bradycardia, or pre-existing cardiac disease. Avoid exposure to strong sunlight or sunlamps during treatment. Discontinue treatment if patients experience tendon pain, inflammation or rupture; subsequent use of fluoroquinolones in these patients is not recommended. Avoid in MRSA infections due to high risk of resistance. Ensure adequate fluid intake to reduce risk of crystalluria.

Pregnancy-Lactation

Interactions

Cations such as aluminum, magnesium, zinc and iron may reduce the bioavailability of sparfloxacin. May increase the plasma concentrations of theophylline and tizanidine. May enhance the effect of warfarin and glibenclamide. May decrease the renal clearance of methotrexate. Excretion may be reduced by probenecid. May alter serum levels of phenytoin. Potentially Fatal: Corticosteroids may increase risk of tendon rupture. Increased risk of seizures with NSAIDs. Risk of additive QT prolongation effect when used with class Ia or III antiarrhythmic drugs, astemizole, terfenadine, cisapride, erythromycin, pentamidine, phenothiazines or TCAs.

Adverse Effects

Side effects of Sparfloxacin : Diarrhoea, abdominal pain, nausea, vomiting; jaundice, renal failure, elevation of liver enzymes, BUN and creatinine; anaphylactoid reaction, headache, dizziness, convulsions; tremors, myalgia; rhabdomyolysis, thrombocytopenia and eosinophilia. Potentially Fatal: AV block; anaphylaxis.

Mechanism of Action

Sparfloxacin inhibits the supercoiling activity of DNA gyrase which is an enzyme essential for DNA replication thus promoting the breakage of DNA structures. It has activity against S. pneumoniae, S. aureus, H. influenzae, K. pneumoniae, M. catarrhalis and Mycobacterium spp.