Brand Name: Veraflox

Available as an oral suspension (tablets in the U.K.)

Background

Human beings have been at odds with microbes since the beginning of time and the quest for new medications continues even today. When sulfa drugs came on the scene in the 1940s, an age of antibiotics was born and a new dimension had opened in the combat against microbes. From there a proliferation of antibiotics developed, each new medication exploiting a different aspect of bacterial metabolism until it seemed that the war on microbes would soon be won.

Despite this progress, one particular bacterial species remained seemingly invincible: Pseudomonas aeruginosa. This species of bacteria was able to change its antibiotic susceptibility with each antibiotic exposure, become resistant to multiple drugs in response to every medication used against it. Eventually, the aminoglycoside class of antibiotics was developed and there was finally a way to kill Pseudomonas fairly reliably but the price was that medication was injectable only, necessitating hospitalization for the patient, and potential kidney damage could result with prolonged use.

A major breakthrough against Pseudomonas came with the development of the fluoroquinolone class of antibiotics (including ciprofloxacin, which was produced for human use, and enrofloxacin for animal use). These medications are active against many bacterial types including Pseudomonas. They are available as tablets and are not associated with the serious side effects that plagued the aminoglycoside group.

Fluoroquinolones act by deactivating bacterial enzymes necessary for the transcription of DNA. DNA is tightly coiled in order to fit inside a cell. Segments of DNA to be used in protein production must be uncoiled by an enzyme called DNA gyrase. Segments of DNA to be used in protein production must be uncoiled by an enzyme called DNA gyrase. The fluoroquinolone antibiotics deactivate DNA gyrase, making it impossible to read the DNA. The bacterial cell dies. Mammalian DNA gyrase is of a completely different shape and remains untouched.

Enrofloxacin became widely used in dogs and cats but before long a problem with feline use came to light. Quinolone antibiotics accumulate in the feline retina and cause decreased vision and even blindness, which may or may not be reversible. It soon became clear that there was a need for a quinolone antibiotic with as little affinity for the feline retina as possible. The product would ideally be in a formulation palatable to cats and convenient to use. Pradofloxacin is the result of these research developments.

How this Medication is Used

As mentioned, pradofloxacin has activity against Pseudomonas, but unlike the other quinolone antibiotics, it has good activity against anaerobic bacteria, which makes it useful against bite wound abscesses.  

Pradofloxacin comes as an oral suspension that should be kept at room temperature in its original packaging. A dosing syringe is provided to facilitate accurate dosing. Shake the bottle before drawing up the dose. 

Pradofloxacin is typically dosed once or twice daily. If a dose is accidentally skipped, do not double up on the next dose. Pradofloxacin enters the body much more readily if given on an empty stomach, but can be given with a small amount of food if nausea is an issue.

Dose adjustment is recommended for patients with kidney or liver disease.

Dairy products contain calcium which will bind quinolone antibiotics so cheese etc. should not be used in as a treat or reward after dosing. 

The product is good for 60 days after the container has been opened.

Side Effects

As with most oral medications, the most common side effects of pradofloxacin are related to the GI tract: vomiting, diarrhea, reduced appetite. Providing a small amount of food should help this problem. 

Pradofloxacin is not approved for use in dogs in the U.S. because of bone marrow suppression issues. In fact, after 7 days of use in cats, the chance of bone marrow suppression increases. Inappropriate weakness, bruising, or pallor of gums would be signs of a problem.

Fluoroquinolone antibiotics may lower the seizure threshold and increase a patient's tendency to have seizures. This is of no concern in a normal animal, but is worth a cautionary statement for patients with a pre-existing seizure disorder.

Interactions with other Drugs

Sucralfate (a medication used to treat stomach ulcers) may bind pradofloxacin and prevent it from entering the body. These medications should be given at least two hours apart if they are used together. A similar phenomenon occurs with magnesium and calcium-containing antacids.

Theophylline (an airway dilator) blood levels may be higher than usual if this medication is used concurrently with pradofloxacin. The dose of theophylline may need to be reduced.

If pradofloxacin is used with oral cyclosporine (an immunosuppressive medication used for inflammatory bowel disease), the kidney-damaging properties of cyclosporine may become worse.

Medications or supplements containing iron, zinc, magnesium, or aluminum will bind pradofloxacin and prevent absorption into the body. Such medications should be separated from pradofloxacin by at least two hours.

Cimetidine (an antacid) interferes with metabolism of pradofloxacin. Dose adjustments of pradofloxacin may be needed.

Quinolone class antibiotics should not be used with cyclosporine as kidney toxicity can result.

Concerns and Cautions

Pradofloxacin should not be used in pregnant or nursing cats, and its safety has not been evaluated in kittens less than 12 weeks of age.

It is our policy not to give dosing information over the Internet.