In this episode, I’ll discuss why moxifloxacin doesn’t cover urinary tract infections.
Imagine the following scenario:
You’re covering multidisciplinary rounds with the hospitalist team when they present a patient who appears to have two infections.
1. Community-acquired pneumonia, for which the patient was admitted for and had a positive sputum culture and infiltrate on the chest X-ray.
2. A UTI for which the patient had 35 WBC/HPF in their urinalysis and pan-sensitive E Coli in their urine culture.
The team comments that they are using moxifloxacin to treat both infections and they move on to the next patient.
Do you catch the problem? Despite the oddity that a patient may have a UTI and CAP at the same time, moxifloxacin can’t be counted on to treat a UTI.
Moxifloxacin doesn’t achieve adequate concentrations in the urine and for this reason, was never approved to treat UTIs. Assuming the patient has two infections, a different quinolone such as levofloxacin would be needed to provide adequate coverage to the patient.
When in doubt whether an antibiotic can be used for a given infection – always look in the prescribing information for an FDA indication. If there is no indication, confirm with a tertiary resource such as Hopkins ABX Guide or Sanford Guide. This is an easy way to make sure you never use an antibiotic for an infection that it doesn’t work for.
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If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.