Absorption Metabolism and Excretion

The quinolones are rapidly and almost completely absorbed after oral administration and are widely distributed in body tissues. Levels in extravascular spaces can often exceed serum levels. Levels lower than those found in serum occur in CSF, bone, and prostatic fluids. Ciprofloxacin and ofloxacin have been detected in breast milk and ofloxacin levels in ascites fluid are close to serum levels. Food ingestion does not affect bioavail-ability, which ranges from 50 to 95%. The half-life for most quinolones is 3 to 4 hours.

Elimination of the fluoroquinolones is through glomerular filtration and tubular secretion. In patients with moderate to severe renal insufficiency, quinolone dosages should be modified. The fluoroquinolones are also metabolized by hepatic conjugation and glu-curonidation. Caution should be observed with administration of trovafloxacin because of its potential to induce hepatic toxicity. Dosage, peak serum levels, percent protein binding, urine concentrations, and degree of metabolism differ to varying degrees among the quinolones.

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