Enoxacin is a 6-fluoronaphthyridinone
antibacterial agent with good in vitro activity against Neisseria gonorrhoeae and most Gram-negative urinary tract pathogens. It is less active in vitro against Acinetobacter spp., Pseudomonas aeruginosa, and most Gram-positive bacteria, than against Gram-negative organisms.
Enoxacin is rapidly absorbed, with a high oral bioavailability (87 to 91%). Of the absorbed dose, 44 to 56% is excreted unchanged in the urine, with peak urinary concentrations (>500 mg/L within 4 hours) remaining high (>100 mg/L) for up to 24 hours, sufficient to inhibit most urinary tract pathogens. Single (400 mg) and multiple oral dose regimens (100 to 600 mg twice or 3 times daily for 5 to 14 days) of
enoxacin are as effective for the treatment of patients with complicated or uncomplicated
urinary tract infections as other
antibacterial agents such as
amoxicillin,
cefuroxime axetil,
cotrimoxazole (
trimethoprim-sulfamethoxazole) or
trimethoprim. Noncomparative data suggest that
enoxacin is also an effective agent for the treatment of
prostatitis. Single 400 mgoral doses of
enoxacin produce >/- 95% bacteriological cure rates in gonococcal
infections, comparable to those produced by single intramuscular doses of
ceftriaxone 250 mg. Perioperative doses of oral
enoxacin 200 mg provide effective prophylaxis against postoperative
bacteriuria after transurethral resection of the prostate. Concomitant administration of
enoxacin with a number of commonly used therapeutic agents (e.g.
antacids, methylxanthines,
warfarin) affects the pharmacokinetic properties of either
enoxacin or the coadministered agents.
Enoxacin is reasonably well tolerated, with the incidence of adverse experiences ranging from 0 to 24%. Adverse events are mainly gastrointestinal, neurological or dermatological and resolve with minimal intervention. Overall, although
enoxacin exhibits a number of clinical characteristics that are similar to those of other agents for the treatment of genitourinary tract
infections, the advantages offered by this agent generally do not outweigh those of alternative
fluoroquinolone agents. Thus, it is likely to prove to be yet another addition to the list of agents available for the management of these
infections.