besifloxacin

besifloxacin

(be-si-flox-a-sin) ,

Besivance

(trade name)

Classification

Therapeutic: anti infectives
Pharmacologic: fluoroquinolones
Pregnancy Category: C

Indications

Treatment of bacterial conjunctivitis.

Action

Inhibits bacterial DNA synthesis by inhibiting DNA gyrase.

Therapeutic effects

Death of susceptible bacteria with decreased symptoms and sequelae of bacterial conjunctivitis.
Active against CDC coryneform group G, Corynebacterium pseudodiphtheriticum, Corynebacterium striatum, Haemophilus influenzae, Moraxella lacunata, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus hominis, Staphylococcus lugdunensis, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae and Streptococcus salivarius.

Pharmacokinetics

Absorption: Minimal absorption follows ophthalmic use.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: 7 hr.

Time/action profile

ROUTEONSETPEAKDURATION
Ophthunknownunknown6–12 hr

Contraindications/Precautions

Contraindicated in: Contact lens use.
Use Cautiously in: Obstetric: Use during pregnancy only if potential benefit justifies potential risk to fetus; Lactation: Use cautiously during lactation; Pediatric: Safe use in children <1 yr not established.

Adverse Reactions/Side Effects

Central nervous system

  • headache

Ear, Eye, Nose, Throat

  • conjunctival redness (most frequent)
  • blurred vision
  • eye irritation
  • eye pain,
  • eye pruritus.

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

Ophthalmic (Adults and Children ≥1 yr) One drop in affected eye(s) three times daily (4–12 h apart) for 7 days.

Availability

Ophthalmic suspension: 0.6% 5 mL in 7.5 mL bottle

Nursing implications

Nursing assessment

  • Assess eye for signs of infection (swelling, redness, pain, discharge) prior to and periodically during therapy.

Potential Nursing Diagnoses

Risk for infection (Indications)

Implementation

  • Ophthalmic: Invert closed bottle and shake once before use. Remove cap with bottle still inverted. Tilt head back and, with bottle inverted, gently squeeze bottle to instill 1 drop in affected eye 3 times daily (4–12 hrs apart) for 7 days.

Patient/Family Teaching

  • Instruct patient to use besifloxacin as directed, even if feeling better. Do not skip doses or stop therapy early; may lead to decreased effectiveness and resistant infections. Avoid touching applicator to eye, finger, or other areas; may contaminate. Wash hands prior to instillation.
  • Caution patient to avoid wearing contact lenses during therapy.
  • Advise patient to discontinue immediately and notify health care professional if signs or rash or allergic reaction (hives, difficulty breathing, swelling of throat) occur.

Evaluation/Desired Outcomes

  • Resolution of signs and symptoms of infection.
References in periodicals archive ?
Aqueous penetration of moxifloxacin 0.5% ophthalmic solution and besifloxacin 0.6% ophthalmic suspension in cataract surgery patients.
chelonae keratitis using fourth generation fluoroquinolones such as topical besifloxacin or gatifloxacin as an adjunct therapy [23,24].
Ocular pharmacokinetics/ pharmacodynamics of besifloxacin, moxifloxacin, and gatifloxacin following topical administration to pigmented rabbits.
Ten anti-infectives are available for topical treatment of eye infections (systemic concentrations if known): besifloxacin (Besivance) (0.43 ng/mL), ciprofloxacin (less than 2.5 ng/mL), gentamicin, gatifloxacin (Zymaxid) (less than 5 ng/mL), levofloxacin (Iquix) (10.9 ng/mL), moxifloxacin (Vigamox) (2.7 ng/mL), ofloxacin (1.9 ng/ mL), sulfacetamide (Isopto Cetamide), and tobramycin.
InSite Vision added that it is advancing new specialty ophthalmic products for the treatment of diseases affecting the front and back of the eye.It has two commercial products based on its innovative DuraSite platform approved for the treatment of bacterial eye infections, AzaSite (azithromycin ophthalmic solution) 1%, marketed in the US by Akorn and Besivance (besifloxacin ophthalmic suspension) 0.6%, marketed by Bausch + Lomb, a wholly owned subsidiary of Valeant Pharmaceuticals.
Tenders are invited for Besifloxacin 0.6 Per Cent Eye Drop
The company has two commercial products based on its innovative DuraSite platform approved for the treatment of bacterial eye infections, AzaSite (azithromycin ophthalmic solution) 1%, marketed in the US by Akorn, Inc., and Besivance (besifloxacin ophthalmic suspension) 0.6%, marketed by Bausch and Lomb, a wholly owned subsidiary of Valeant Pharmaceuticals International.
(15) However, studies supporting the use of antibiotics in secondary care involving selected patients, such as polymixin-bacitracin, azithromycin, besifloxacin, moxifloxacin, ciprofloxacin and norfloxacin, produce a statistically significant and faster improvement in clinical resolution or bacterial eradication compared to placebo.
According to the company, Besivance (besifloxacin ophthalmic suspension) 0.6% is marketed globally by Bausch + Lomb for the treatment of bacterial conjunctivitis.
Topoisomerase Mutations That Are Associated with High-Level Resistance to Earlier Fluoroquinolones in Staphylococcus aureus Have Less Effect on the Antibacterial Activity of Besifloxacin. Chemotherapy 2011;57:363-71.
Efficacy and safety of besifloxacin ophthalmic suspension 0.6% in children and adolescents with bacterial conjunctivitis: a post hoc, subgroup analysis of three randomized, double-masked, parallel-group, multicenter clinical trials.