Fluoroquinolones are a class of antibiotics characterized by the common “-floxacin” suffix. Common examples include ciprofloxacin and levofloxacin. This class is widely used due to its broad-spectrum activity and effectiveness against a variety of infections.
What Do Fluoroquinolones Target?
Fluoroquinolones have broad-spectrum coverage, making them effective against:
- Gram-negative bacteria (primary target)
- Some gram-positive bacteria
They are commonly used to treat:
- Urinary tract infections (UTIs)
- Respiratory infections
- Gastrointestinal infections
- Skin infections
How They Work?
Fluoroquinolones work by inhibiting bacterial DNA replication:
- DNA gyrase inhibition primarily affects gram-negative bacteria
- Topoisomerase IV inhibition targets gram-positive bacteria
This bactericidal effect stops bacteria from multiplying and effectively clears infections.
Lecture on Fluoroquinolones
Key Nursing and Safety Considerations
A useful way to remember the important aspects of fluoroquinolones is through the word “FLOXACIN”:
F – Fluids intake is key! Adequate hydration is essential, particularly with ciprofloxacin, to prevent crystalluria and kidney injury.
L – Long QT Interval: Monitor ECG if the patient is taking other QT-prolonging drugs like amiodarone.
O – Older Adults / Tendon Risk: Elderly patients are at higher risk for tendon rupture, especially the Achilles tendon. Risk increases with concurrent corticosteroid use. Instruct patients to report pain, swelling, or a snapping sensation immediately.
X – Don’t given with Antacids, Calcium, Iron, and Dairy: These can reduce absorption of fluoroquinolones.
A – Avoid in Children & Pregnancy: Can cause bone and cartilage problems in growing children.
C – C.diff risk (monitor for frequent, foul-smelling, watery stool)
I – Increased sun sensitivity (wear sunscreen and avoid tanning booths)
N – Neuro effects: dizziness, headache, confusion (especially in elderly)
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References:
National Library of Medicine. (2019). Levofloxacin. MedlinePlus. Retrieved June 2, 2025, from https://medlineplus.gov/druginfo/meds/a697040.html
U.S. Food and Drug Administration. (2016). CIPRO (ciprofloxacin hydrochloride) tablets, for oral use; CIPRO (ciprofloxacin hydrochloride), for oral suspension (NDA 019537, S-086). https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019537s086lbl.pdf