Delafloxacin
Fluoroquinolones
Fluoroquinolones
Newer oral and intravenous fluoroquinolone with strong activity against staphylococci; used for skin infections and community-acquired pneumonia.
Also called: delafloxacin meglumine
Quick facts
- Group
- Fluoroquinolones
- Target
- Bacterial topoisomerase IV and DNA gyrase
- Used for
- Acute bacterial skin
- Key effects
- Nausea · Headache
- Monitor
- Tendon pain or swelling · Stools
- ATC
- J01MA23
No doses: the clinician sets them by the current guideline.
Mechanism of action
The figure shows delafloxacin itself trapping the DNA cut by topoisomerase IV of Streptococcus pneumoniae.
Like the other fluoroquinolones, delafloxacin binds the complex of DNA with topoisomerase IV and DNA gyrase and freezes it after the enzyme has cut the DNA. The double-strand breaks that build up kill the bacterium. Compared with older members it is much more potent against Staphylococcus aureus, while its activity against gram-negative bacteria, Pseudomonas included, is about that of levofloxacin.
- Binds topoisomerase IV and DNA gyrase bound to DNA
- Locks the enzyme after it has cut both DNA strands
- DNA breaks accumulate and replication stops
- The bacterium dies (bactericidal)
Indications
- Acute bacterial skin and skin-structure infections, including those by staphylococci Cellulitis of the leg →
- Community-acquired bacterial pneumonia Community-acquired pneumonia →
Adverse effects
Common
- Nausea, vomiting and diarrhoea
- Headache
Contraindications
- Allergy to delafloxacin or another fluoroquinolone
Key interactions
- Antacids and supplements with aluminium, magnesium, iron or zinc; sucralfate
- They bind the drug in the gut and lower its absorption; the oral dose is separated from them by several hours.
- Antidiabetic medicines (insulin, sulfonylureas)
- Blood sugar can fall or rise more than expected; glucose is checked more often.
- Corticosteroids
- They add to the risk of tendon rupture, as with every fluoroquinolone.
What is monitored
- Tendon pain or swelling, numbness or tingling, and changes in mood or thinking
- Blood glucose in people with diabetes
- Stools: watery or bloody diarrhoea
Administration and safety
- Oral tablets or an intravenous infusion; the IV powder is reconstituted and diluted following the product instructions
- Oral doses are kept apart from antacids, iron, zinc, magnesium and sucralfate
- Name looks like other «-floxacin» drugs: the label is checked before giving it
Pregnancy and breastfeeding
Human data are lacking; it is used in pregnancy only when no better-studied alternative fits.
Nursing care
- Ask about tendon problems, myasthenia gravis, aortic aneurysm, diabetes and allergy to quinolones
- Teach to stop and report tendon pain, tingling, chest or back pain or confusion
- Check blood sugar more often in people with diabetes
- Watch for diarrhoea during treatment and up to two months later
Pharmacokinetics
- Absorption
- Given by mouth or by intravenous infusion.
- Elimination
- Mixed: part by the kidneys and part by other routes; kidney function is taken into account.
Test yourself
Think of the answer, then tap the question to see it.
Which two bacterial enzymes does delafloxacin block?
Topoisomerase IV and DNA gyrase, which it traps after they have cut the DNA.
What sets delafloxacin apart from levofloxacin in its spectrum?
It is far more potent against Staphylococcus aureus, while its gram-negative activity is similar.
Which serious effects appear in the boxed warning of all fluoroquinolones, delafloxacin included?
Tendinitis and tendon rupture, peripheral neuropathy, central nervous system effects and worsening of myasthenia gravis.
Why are oral delafloxacin doses separated from antacids and iron?
Aluminium, magnesium, iron and zinc bind the drug in the gut and reduce its absorption.
Connections
← Back to the class: Fluoroquinolones
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Delafloxacin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026); High resolution structure of the Streptococcus pneumoniae topoisomerase IV-DNA complex with the novel fluoroquinolone Delafloxacin (RCSB Protein Data Bank, 2026); DailyMed - LEVOFLOXACIN tablet, film coated (DailyMed (U.S. National Library of Medicine), 2026).
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Representative model, for educational purposes only.