Indications: sinusitis, community-acquired pneumonia, exacerbations of chronic bronchitis, mild to moderate pelvic inflammatory disease, or complicated skin and soft-tissue infections which have failed to respond to other antibacterial or for patients who cannot be treated with other antibacterial.

Cautions: should be used with caution in patients with a history of epilepsy or conditions that predispose to seizures, in G6PD deficiency, myasthenia gravis (risk of exacerbation), and in children or adolescents (arthropathy has developed in weight-bearing joints in young animals). Exposure to excessive sunlight should be avoided (discontinue if photosensitivity occurs).

Contra-indications: patients with risk factors for QT interval prolongation (e.g. electrolyte disturbances, acute myocardial infarction, heart failure with reduced left ventricular ejection fraction, bradycardia, congenital long QT syndrome. history of symptomatic arrhythmias.

Hepatic impairment: manufacturer advises avoid in severe impairment.

Side Effects: nausea, vomiting, diarrhoea (rarely antibiotic-associated colitis), headache, and dizziness. Less frequent side effects include dyspepsia, abdominal pain, anorexia, sleep disturbances, asthenia, confusion, anxiety, depression, hallucinations, tremor, blood disorders (including eosinophilia, leucopenia, thrombocytopenia), arthralgia, myalgia, rash (very rarely Stevens-Johnson syndrome and toxic epidermal necrolysis), disturbances in vision and taste.

Pregnancy: Quinolones should be avoided in pregnancy because they have been shown to cause arthropathy in animal studies

Breast-feeding: manufacturer advises avoid—present in milk in animal studies

Dose: By mouth, 400 mg once daily

By intravenous infusion over 60 minutes, community- acquired pneumonia, complicated skin and soft-tissue infections, 400 mg once daily.