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Lomefloxacin HCl Uses Lomefloxacin is used orally in adults for the treatment of mild to moderate lower respiratory tract infections (acute bacterial exacerbations of chronic bronchitis) and uncomplicated or complicated urinary tract infections caused by susceptible organisms. The drug also is used orally for perioperative prophylaxis in patients undergoing transrectal prostate biopsy or transurethral surgical procedures. Respiratory Tract Infections Lomefloxacin is used for the treatment of mild to moderate acute exacerbations of chronic bronchitis caused by susceptible Haemophilus influenzae or Moraxella catarrhalis. Because Streptococcus pneumoniae exhibits resistance to lomefloxacin in vitro and the safety and efficacy of the drug in lower respiratory tract infections caused by this organism have not been demonstrated, the drug should not be used for the empiric treatment of respiratory tract infections, including acute bacterial exacerbations of chronic bronchitis, when it is probable that S. pneumoniae is the causative organism. If empiric therapy is to be undertaken and lomefloxacin therapy is considered, it should be guided by a Gram stain of the sputum; the drug should only be considered for such therapy if the Gram stain demonstrates an adequate quality of specimen (e.g., greater than 25 polymorphonuclear neutrophils per low-power field) and there is a predominance of gram-negative bacteria and not a predominance of gram-positive bacteria. When lomefloxacin is used for the treatment of UTIs caused by Ps. aeruginosa, the possibility of associated bacteremia should be considered; the manufacturer warns that safety and efficacy of the drug in the treatment of pseudomonal bacteremia have not been established, and serum concentrations achieved with currently recommended oral dosages of lomefloxacin do not reliably exceed the MIC for this organism. Perioperative Prophylaxis When lomefloxacin is used perioperatively to reduce the incidence of UTIs in patients undergoing transrectal prostate biopsy, the drug usually is administered as a single dose 1-6 hours prior to the procedure in an attempt to reduce infections that might develop during the early (3-5 days) and late (3-4 weeks) postoperative period. When lomefloxacin is used perioperatively to reduce the incidence of UTIs in patients undergoing transurethral surgical procedures, the drug usually is administered as a single dose 2-6 hours prior to the procedure in an attempt to reduce infections that might develop during the early postoperative period (3-5 days). Efficacy of the drug in reducing the incidence of early postoperative infections other than UTIs has not been established. Lomefloxacin should not be used prophylactically in patients undergoing minor urologic procedures, such as simple cystoscopy or retrograde pyelography, for which prophylaxis is not indicated. Gonorrhea and Associated Infections Oral lomefloxacin is one of several single-dose alternative regimens recommended by the US Centers for Disease Control and Prevention (CDC) for the treatment of uncomplicated cervical, urethral, or rectal gonorrhea in adults and adolescents. The CDC states that, although the single-dose lomefloxacin regimen appears to be effective for the treatment of uncomplicated gonorrhea, clinical experience with the regimen is limited and it does not appear to offer any advantage over currently recommended single-dose regimens of ciprofloxacin, ofloxacin, or levofloxacin.