Delafloxacin

How it works

It inhibits the bacterial enzymes DNA gyrase and topoisomerase IV, blocking DNA replication and transcription and leading to bacterial cell death.

Prescribing in practice

• Fluoroquinolones carry a risk of disabling and potentially long-lasting or irreversible adverse effects on tendons, muscles, joints, and the nervous system, so MHRA advises restricting use to situations where other antibacterials are unsuitable.
• Tendon rupture and aortic aneurysm or dissection have been associated with fluoroquinolones, with greater risk in older patients and those on corticosteroids.
• They may prolong the QT interval and can cause central nervous system effects including seizures.

Monitoring

Monitor for tendon, musculoskeletal, neurological, and psychiatric adverse effects, and stop treatment at the first sign of a serious reaction.

Counselling the patient

• Stop the medicine and seek advice immediately if you develop tendon pain or swelling, or new neurological or psychiatric symptoms.
• Avoid taking indigestion remedies, or iron and other mineral supplements, around the same time as the dose.

Evidence & guidelines

MHRA safety guidance on systemic fluoroquinolones underpins the restricted-use recommendation, with efficacy demonstrated in randomised trials for skin and respiratory infections.