Trovafloxacin mesylate
Trovafloxacin mesylate (Trovan)
Trovafloxacin/Alatrofloxacin
( TROH-vah- FLOX-ah-sin)
Pregnancy Category: C Trovan (Rx)
Alatrofloxacin mesylate injection
Alatrofloxacin mesylate injection (Trovan I.V.)
Trovafloxacin/Alatrofloxacin
(al- AY-troh- flox-ah-sin)
Pregnancy Category: C Trovan I.V. (Rx)

Classification: Broad-spectrum antibiotic related to fluoroquinolines

See Also: See also Fluoroquinolines.

Action/Kinetics: After IV use, alatrofloxacin is rapidly converted to trovafloxacin. Trovafloxacin is rapidly absorbed from GI tract. t 1/2, trovafloxacin: 10.5-12.2 hr, depending on dose and after multiple doses. t 1/2, alatrofloxacin: 11.7-12.7 hr, depending on dose and after multiple doses. About 50% excreted unchanged in urine and feces; remainder is metabolized by liver.

Uses: IV, PO: (1) Nosocomial pneumonia caused by Escherichia coli, Pseudomonas aeruginosa, Haemophilus influenzae, or Staphylococcus aureus. (2) Community acquired pneumonia caused by Streptococcus pneumoniae, H. influenzae, Klebsiella pneumoniae, S. aureus, Mycoplasma pneumoniae, Moraxella catarrhalis, Legionella pneumophila, or Chlamydia pneumoniae. (3) Complicated intra-abdominal infections, including post-surgical infections caused by E. coli, Bacteroides fragilis, viridans group streptococci, P. aeruginosa, K. pneumoniae, Peptostreptococcus species, or Prevotella species. (4) Gynecologic or pelvic infections, including endomyometritis, parametritis, septic abortion, and post-partum infections caused by E. coli, B. fragilis, viridans group streptococci, Enterococcus faecalis, Streptococcus agalactiae, Peptostreptococcus species, Prevotella species, or Gardnerella vaginalis. (5) Uncomplicated skin and skin structure infections, including diabetic foot infections, due to S. aureus, S. pyogenes, or S. agalactiae. Complicated skin and skin structure infections, including diabetic foot infections due to S. aureus, S. agalactiae, P. aeruginosa, E. faecalis, E.coli, or Proteus mirabilis.

Contraindications: Use in those with history of hypersensitivity to trovafloxacin, alatrofloxacin, or quinolone antimicrobial agents. Use when safer, alternative antimicrobial drugs will be effective.

Special Concerns: Safety and efficacy in children less than 18 years of age, in pregnant women, and during lactation have not been studied. Serious liver injury, leading to liver transplantation or death, may occur especially if used for over 2 weeks. Reserve use for clients with serious, life-, or limb-threatening infections where initial treatment is in a hospital or long-term nursing facility and the provider believes the benefits outweigh the potential risks.

Side Effects: Side effects listed occur at rate of 1% or greater. GI: N&V;, diarrhea, abdominal pain. CNS: Dizziness, headache, lightheadedness. Dermatologic: Pruritus, rash. Miscellaneous: Vaginitis, reaction at injection site, eosinophila.

Laboratory Test Alterations: Platelets, ALT, AST, alkaline phosphatase, BUN, creatinine. Hemoglobin, hematocrit, protein, albumin, sodium, bicarbonate. or WBCs.

Drug Interactions: Aluminum hydroxide / Plasma levels of trovafloxacin Ferrous sulfate / Plasma levels of trovafloxacin Magnesium hydroxide / Plasma levels of trovafloxacin Morphine / Plasma levels of trovafloxacin Omeprazole / Plasma levels of trovafloxacin Sucralfate / Plasma levels of trovafloxacin Warfarin / INR

How Supplied: Tablets (Trovafloxacin mesylate): 100 mg, 200 mg; Injection (Alatrofloxacin mesylate): 5 mg/mL

Dosage
?IV, Tablets Nosocomial pneumonia.
300 mg IV followed by 200 mg PO for 10-14 days. If due to P. aeruginosa combination therapy with either aminoglycoside or aztreonam may be indicated.
Community acquired pneumonia.
200 mg PO or 200 mg IV followed by 200 mg PO for 7-14 days.
Complicated intra-abdominal infections, including post-surgical infections.
300 mg IV followed by 200 mg PO for 7-14 days.
Gynecologic and pelvic infections.
300 mg IV followed by 200 mg PO for 7-14 days.
Skin and skin structure infections, uncomplicated.
100 mg PO for 7-10 days.
Skin and skin structure infections, complicated, including diabetic foot infections.
200 mg PO or 200 mg IV, followed by 200 mg PO for 10-14 days.