Ofloxacin

How it works

It inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA supercoiling and replication and producing a bactericidal effect.

Prescribing in practice

• The MHRA advises systemic fluoroquinolones may cause disabling, potentially long-lasting or irreversible tendon, muscle, joint and nervous-system effects, and they should be reserved for when other antibiotics cannot be used.
• Tendon rupture risk is higher in older patients, those on corticosteroids and those with renal impairment, and any tendon pain warrants stopping treatment.
• It lowers the seizure threshold and can prolong the QT interval, so caution applies in epilepsy and with other QT-prolonging drugs.

Monitoring

Monitor for tendon, neurological and psychiatric symptoms during and after treatment, with cardiac assessment where QT risk factors exist.

Counselling the patient

• Stop and seek advice if you get tendon pain or swelling, new numbness or tingling, or changes in mood.
• Avoid excessive sun exposure as the skin may become more sensitive to light.

Evidence & guidelines

Reserve-use restrictions follow MHRA Drug Safety Updates, and antibacterial efficacy is established in the SPC.