Oxadel 300 IV Infusion

Indications

Delafloxacin is a fluoroquinolone antibiotic used in adults to treat serious bacterial skin and skin structure infections (such as cellulitis, wound infections and abscesses), including some caused by MRSA, and community-acquired pneumonia caused by bacteria that it can kill. It is not effective against viral infections such as colds or flu.

How It Works

Delafloxacin blocks two bacterial enzymes, DNA gyrase and topoisomerase IV, which bacteria need to copy and repair their DNA. Without them the bacteria cannot multiply and die. It works against many Gram-positive bacteria (including Staphylococcus) and Gram-negative bacteria.

Dosage and Administration

Tablets: the usual adult dose is 450 mg every 12 hours, with or without food, for the number of days your doctor prescribes (often 5 to 14 days). The injection is given as a slow intravenous infusion by a doctor or nurse in hospital, and treatment may be switched from injection to tablets. Doses are adjusted in severe kidney disease. Finish the whole course even if you feel better.

Interactions

• Antacids containing Magnesium or Aluminium, Sucralfate, and supplements or multivitamins with Iron or Zinc: these block absorption. Take Delafloxacin at least 2 hours before or 6 hours after them.
• Corticosteroids: higher risk of tendon damage, especially in older people.
• Diabetes medicines such as insulin or sulfonylureas: blood sugar may become too low or too high.
• NSAIDs: may increase the risk of seizures.
• Warfarin: bleeding risk may rise; INR should be checked.

Contraindications

• Allergy to Delafloxacin or any other fluoroquinolone antibiotic (such as Ciprofloxacin or Levofloxacin).
• People with myasthenia gravis should generally avoid it, as it can worsen muscle weakness.

Side Effects

Common effects are nausea, diarrhoea, headache, raised liver enzymes and vomiting. Like other fluoroquinolones it can rarely cause tendon inflammation or rupture, nerve damage causing tingling or burning, mood changes, confusion, sleep problems, low or high blood sugar, and severe diarrhoea due to Clostridioides difficile infection.

Get urgent medical help if you have sudden pain, swelling or a snap in a tendon (often the heel), numbness or burning in the hands or feet, muscle weakness or trouble breathing, severe or bloody diarrhoea, a serious rash or swelling of the face or throat, sudden severe chest, back or stomach pain, fainting, or confusion and hallucinations.

Pregnancy and Lactation

There is little information on use in pregnancy. It should be used only if your doctor thinks the benefit clearly outweighs any risk. It is not known if it passes into breast milk; your doctor may advise pausing breastfeeding during treatment and for a short time afterwards.

Precautions and Warnings

Fluoroquinolones carry warnings about disabling and possibly lasting effects on tendons, muscles, joints, nerves and the brain. They are usually kept for infections where other antibiotics are unsuitable. Tell your doctor if you are over 60, have had a transplant, have kidney disease, epilepsy, diabetes, an aortic aneurysm or a past tendon problem. Stop and call your doctor at the first sign of tendon pain or nerve symptoms. Avoid strenuous exercise if tendons hurt.

Overdose

An overdose may cause nausea, vomiting, dizziness or more severe side effects. Contact a doctor or poison centre straight away. Treatment is supportive and the person should be monitored.

Therapeutic Class

Antibacterial, fluoroquinolone (quinolone).

Storage

Tablets: store below 30°C in a dry place, away from light and out of the reach of children. Injection vials: store as directed on the pack; hospital staff prepare the infusion.