BACKGROUND AND OBJECTIVEManaging drug-food interactions is essential for optimizing the effectiveness and safety profile of quinolones. Following PRISMA guidelines, we systematically reviewed the influence of dietary interventions on the bioavailability of 22 quinolones.METHODSAll studies describing or investigating the impact of food, beverages, antacids, and mineral supplements on pharmacokinetic parameters or pharmacokinetic/pharmacodynamic indices of orally taken quinolones were considered for inclusion. We excluded reviews, in vitro and in silico studies, studies performed on animals, and those involving alcohol. We performed the search in Medline (via PubMed), Embase, and Cochrane Library, covering reports from database inception to December 2022. We used the following tools to assess the risk of bias: version 2 of the Cochrane risk-of-bias tool for parallel trials, the Cochrane risk-of-bias tool for cross-over studies, and the NIH quality assessment tool for before-after studies. We performed quantitative analyses for each quinolone if two or more food-effect studies with specified and comparable study designs were available. If meta-analyses were not applicable, we qualitatively summarized the results.RESULTSWe included 109 studies from 101 reports. Meta-analyses were conducted for 12 antibiotics and qualitative synthesis was employed for the remaining drugs. Of the studies, 60.5% were open-label, cross-over, as recommended by FDA. We judged 46% of studies as having a high risk of bias and only 4% of having a low risk of bias. Among 19 quinolones with available food impact data, 14 (74%) had potentially clinically important interactions. For nalidixic acid, oxolinic acid, and tosufloxacin, food exerted a high positive impact on bioavailability (AUC or C_max increased by > 45%), whereas, for all the remaining drugs, postprandial absorption was lower. The most significant negative influence of food (AUC or C_max decreased by > 40%) occurred for delafloxacin capsules and norfloxacin, whereas the moderate influence (AUC or C_max decreased by 30-40%) occurred for nemonoxacin and rufloxacin. All 14 analysed quinolones showed a substantial reduction in bioavailability when co-administered with antacids and mineral supplements, except for calcium preparations. The impact of beverages was evaluated for 10 quinolones, with 50% experiencing significantly reduced absorption in the presence of milk (the highest negative impact for ciprofloxacin). Moreover, both ciprofloxacin and levofloxacin demonstrated compromised bioavailability when consumed with orange juice, particularly calcium-fortified.DISCUSSIONSeveral factors may influence interactions, including the physicochemical characteristics of quinolones, the type of intervention, drug formulation, and the patient's health status. We assessed the quality of evidence as low due to the poor actuality of included studies, their methodological diversity, and uneven data availability for individual drugs.

01 Dec 2018·European Journal of Clinical Microbiology & Infectious DiseasesQ3 · MEDICINE

A systematic review of randomised clinical trials for oral antibiotic treatment of acute pyelonephritis

Q3 · MEDICINE

Review

Author: Cattrall, Jonathan W S ; Robinson, Alyss V ; Kirby, Andrew

There is increasing resistance to the oral antibiotics currently recommended for the treatment of pyelonephritis, and increased healthcare costs are associated with the reliance on alternative intravenous agents. We, therefore, performed a systematic review of randomised controlled trials to determine the clinical efficacy and safety of oral antibiotics for the treatment of pyelonephritis in adults. A search of four major medical databases (MEDLINE, Embase+ Embase classic, CENTRAL and Cochrane Database for Systematic Reviews) in addition to manual reference searching of relevant reviews was conducted. Clinical cure and adverse event rates were reported, and trial quality and bias were assessed. A total of 277 studies were reviewed; five studies matched all eligibility criteria and were included. Antibiotics included were cefaclor, ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin, loracarbef, norfloxacin, rufloxacin and trimethoprim-sulfamethoxazole. In included studies, the clinical success of the outpatient treatment of pyelonephritis by cefaclor, ciprofloxacin and norfloxacin at 4 to 6 weeks was comparable at between 83 to 95%. Relatively high rates of adverse events were noted in a trial of ciprofloxacin (24%) and trimethoprim-sulfamethoxazole (33%). Significant heterogeneity between all aspects of the trial designs was identified, with all studies having a potential for bias. This review demonstrates a need for high-quality clinical trials into the oral antibiotic treatment of pyelonephritis, with more consistent designs and reporting of outcomes. There are data to support further research into oral norfloxacin and cefaclor for the outpatient treatment of pyelonephritis in adults.

01 Mar 2018·Food ChemistryQ1 · AGRICULTURAL & FORESTRY SCIENCE

Hexafluoroisopropanol-induced salt-free catanionic surfactant coacervate extraction method for determination of fluoroquinolones in milk samples

Q1 · AGRICULTURAL & FORESTRY SCIENCE

Article

Author: Xiao, Yuxiu ; Xu, Jia ; Li, Cao ; Chen, Jia ; Li, Xiao

Coacervation and phase separation were first reported in salt-free catanionic surfactant aqueous systems based on lauric acid (LA) and dodecyltrimethylammonium hydroxide (DTAOH), using hexafluoroisopropanol (HFIP) as a coacervate-inducing agent. The liquid-liquid two-phase separation occurs over a wide of LA/DTAOH molar ratios (78:22-0:100mol/mol) and total surfactant concentrations (5-200mmolL^-1) upon adding a small amount of HFIP (<10%, v/v). HFIP-induced salt-free LA/DTAOH catanionic surfactant system has much wider two-phase region than HFIP-induced salt-containing sodium laurate/dodecyltrimethylammonium bromide system. A HFIP-induced LA/DTAOH coacervate extraction method was established and coupled to high-performance liquid chromatography-ultraviolet detector (HPLC-UV) for determination of fluoroquinolones (rufloxacin, ciprofloxacin, danofloxacin, enrofloxacin) in milk. Detection limits are from 0.3ngmL^-1 to 1.4ngmL^-1. Intra- and inter-day precisions (n=6) are in range of 4.5-8.3% and 5.8-10.7%, respectively. Recoveries are from 87.8% to 109.0%. The method, HFIP-induced salt-free coacervate extraction with HPLC-UV, is suitable for detecting trace fluoroquinolones in milk.

100 Deals associated with Rufloxacin Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D08496	Rufloxacin Hydrochloride	J01MA10	DB13772

R&D Status

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Indication	Country/Location	Organization	Date
Urinary Tract Infections	IT	-	24 Feb 1998
Respiratory Tract Infections	IT	-	19 Feb 1998
Bacterial Infections	PK	Hilton Pharma (Pvt) Ltd.	07 Jul 1996

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Indication	Highest Phase	Country/Location	Organization	Date
Bacterial Infections	Phase 2	DE	-	-
Bacterial Infections	Phase 2	FR	-	-
Bacterial Infections	Phase 2	CH	-	-
Bacterial Infections	Phase 2	AT	-	-

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