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J Antimicrob Chemother. 2018 Jun 1;73(6):1439-1451. doi: 10.1093/jac/dkx543.

Clinical review of delafloxacin: a novel anionic fluoroquinolone.

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Department of Pharmacy, Upstate Medical University Hospital, Syracuse, NY, USA.
Department of Pharmacology, Upstate Medical University, Syracuse, NY, USA.
Division of Infectious Diseases, Upstate Medical University, Syracuse, NY, USA.
Department of Microbiology and Immunology, Upstate Medical University, Syracuse, NY, USA.
Department of Pharmacy Practice, Binghamton University School of Pharmacy and Pharmaceutical Sciences, Binghamton, NY, USA.
Department of Medicine, Upstate Medical University, Syracuse, NY, USA.


Delafloxacin is a novel anionic fluoroquinolone (FQ) approved for treatment of acute bacterial skin and skin structure infections (ABSSSIs) caused by a number of Gram-positive and Gram-negative organisms including MRSA and Pseudomonas aeruginosa. The unique chemical structure of delafloxacin renders it a weak acid and results in increased potency in acidic environments. In Phase III studies, delafloxacin had similar outcomes to comparator regimens for treatment of ABSSSIs, and was well tolerated overall. Similar to other FQs, delafloxacin is available in both intravenous and oral formulations, but differs in that delafloxacin exerts a minimal effect on cytochrome P450 enzymes and on the corrected QT interval. This novel FQ has the potential to be utilized across a wide variety of clinical settings; however, post-marketing surveillance and long-term safety and resistance data will be essential to identify optimal use scenarios.


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