Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota Minneapolis, MN, USA.
Ther Clin Risk Manag. 2006 Dec;2(4):417-34. doi: 10.2147/tcrm.2006.2.4.417.
Moxifloxacin is a recent addition to the fluoroquinolone class, differing from ciprofloxacin and other older agents in having much better in vitro activity against Gram-positive aerobes while retaining potent activity against Gram-negative aerobes. It is also active against the pathogens of human and animal bite wounds and those species of atypical mycobacteria associated with dermatologic infections. Its activity against anaerobes is quite variable. Moxifloxacin penetrates well into inflammatory blister fluid and muscle and subcutaneous adipose tissues. Moxifloxacin should thus be a reasonable option for the treatment of skin and skin structure infections (SSSIs). In 3 randomized controlled trials (RCTs), oral moxifloxacin was as effective as cephalexin in the treatment of uncomplicated SSSIs in adults while in 2 RCTs, intravenous/oral moxifloxacin was as effective as intravenous/oral beta-lactam/beta-lactamase inhibitor therapy in the treatment of complicated SSSIs in adults. Moxifloxacin does not inhibit cytochrome P450 enzymes and thus interact with warfarin or methylxanthines. However, multivalent cations can reduce its oral bioavailability substantially. Dosage adjustment is not required in the presence of renal or hepatic impairment. The clinical relevance of its electrophysiologic effects (QT(c) prolongation) remains unresolved.
莫西沙星是氟喹诺酮类的最新药物，与环丙沙星和其他较老的药物相比，它对革兰阳性需氧菌具有更好的体外活性，同时对革兰阴性需氧菌保持强大的活性。它还对人咬伤和动物咬伤的病原体以及与皮肤感染相关的非典型分枝杆菌具有活性。它对厌氧菌的活性差异很大。莫西沙星能很好地渗透到炎症性水疱液、肌肉和皮下脂肪组织中。因此，莫西沙星应该是治疗皮肤和皮肤结构感染（SSSIs）的合理选择。在 3 项随机对照试验（RCT）中，口服莫西沙星在治疗成人单纯性 SSSIs 方面与头孢氨苄一样有效，而在 2 项 RCT 中，静脉注射/口服莫西沙星与静脉注射/口服β-内酰胺/β-内酰胺酶抑制剂治疗成人复杂性 SSSIs 一样有效。莫西沙星不抑制细胞色素 P450 酶，因此不会与华法林或黄嘌呤相互作用。然而，多价阳离子会大大降低其口服生物利用度。在存在肾或肝损伤的情况下，不需要调整剂量。其电生理效应（QT(c)延长）的临床相关性尚未解决。
