DNA gyrase inhibitor
- Prevents DNA supercoiling and replication (gyrase ± topoisomerase IV)
- Bactericidal
- Blocks bacterial DNA supercoiling — the fluoroquinolones
- Tendinopathy, QT prolongation, CNS effects
- Lowers seizure threshold
Drugs with this mechanism (13)
- Ciprofloxacin — Fluoroquinolone with strong Gram-negative and anti-pseudomonal activity; tendon warnings.
- Delafloxacin — Anionic fluoroquinolone with MRSA activity, which is unusual for the class.
- Enoxacin — Fluoroquinolone antibiotic; a potent CYP1A2 inhibitor with seizure risk.
- Gatifloxacin — Ophthalmic fluoroquinolone for bacterial conjunctivitis; systemic use ended after severe dysglycemia.
- Gemifloxacin — Respiratory fluoroquinolone for pneumonia and bronchitis, notable for rash in younger women.
- Gepotidacin — First-in-class oral bacterial topoisomerase inhibitor for uncomplicated UTI and limited-option gonorrhea.
- Levofloxacin — Respiratory fluoroquinolone; once-daily coverage including atypical pneumonia.
- Moxifloxacin — Respiratory fluoroquinolone with anaerobic coverage; QT prolongation risk.
- Nemonoxacin — Nonfluorinated quinolone antibiotic used in some countries for community-acquired pneumonia; inhibits bacterial DNA gyrase and topoisomerase IV.
- Norfloxacin — Early fluoroquinolone for urinary infections, superseded by later agents in the class.
- Ofloxacin — Fluoroquinolone now mostly used as otic and ophthalmic drops.
- Sparfloxacin — Fluoroquinolone withdrawn for QT prolongation and severe phototoxicity.
- Zoliflodacin — First-in-class oral DNA-gyrase inhibitor for uncomplicated urogenital gonorrhea.
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