Gatifloxacin eye drops (Zymaxid) are used to treat bacterial eye infections that are susceptible to treatment. It is a quinolone-class broad-spectrum antibiotic that is active against a variety of gram-positive and gram-negative organisms and is available as an eye solution.

Gatifloxacin Uses:

• Conjunctivitis:

  • It is indicated for the treatment of bacterial conjunctivitis caused by:
    • Staphylococcus aureus,
    • Staphylococcus epidermidis,
    • Streptococcus mitis group,
    • Streptococcus oralis,
    • Streptococcus pneumoniae, and
    • Haemophilus influenzae.

• Off Label Use of Gatifloxacin in Adults:

  • Bacterial keratitis

Gatifloxacin Eye Drops Dose in Adults

Gatifloxacin Eye Drops Dose in the treatment of Bacterial conjunctivitis:

• Zymar [Canadian product]:

  • Days 1 and 2:
    • One drop should be injected into the afflicted eye every two hours during the day or while awake, up to eight times each day.
  • Days 3 to 7:
    • While awake, place one drop into the troubled eye each of the four times per day (during daytime).

• Zymaxid:

  • Day 1:
    • Instill one drop into the affected eye every two hours while awake during daytime up to a maximum of 8 times per day.
  • Days 2 to 7:
    • Instill one drop into the affected eye 2 to 4 times per day while awake.

Dose in the treatment of Bacterial keratitis (off-label):

• Ophthalmic:
  • Instill one drop into the affected eyes every one hour (around the clock) for the usual duration of 48 to 72 hours until healing begins.
  • The frequency of dosing is then gradually reduced and stopped when the ulcer is completely healed.
  • Different tapering regimens may be used, one suggested tapering regimen is as follows:
    • Days 3 to 6: Instill one drop into the affected eye every two hours around the clock for about three days (after the third day).
    • Days 7 to 9: Every two hours while awake, put one drop into the afflicted eye.
    • Day 9 and on: Pour one drop into the injured eye every six hours until the ulcer has fully healed.
  • Note:
    • A loading dose of one drop every 5 to 15 minutes for the first one to two hours may be considered in patients with central or severe keratitis.

Gatifloxacin Eye Drops Dose in Children

Gatifloxacin Eye Drops dose in the treatment of Bacterial conjunctivitis:

• Children older than 1 year and Adolescents:

  • Zymaxid:
    • Day 1: Up to eight times a day, apply one drop to the affected eye while awake, every two hours.
    • Days 2 to 7: While awake, place one drop into the troubled eye two to four times per day.

Pregnancy Risk Category: C

• After ophthalmic usage, only a very small amount of the drug is absorbed.
• The lowest effective dose for the shortest period of time is what the manufacturers advise.
• It is recommended that you occlude your punctum for at least 3 to 5 minutes after instillation to minimize systemic absorption.

Gatifloxacin use during breastfeeding:

• It is unknown if the drug will be excreted into breastmilk.
• Manufacturers recommend that you stop using the drug and/or breastfeed.
• This is based on the potential benefits to the mother as well as the risks for the baby from drug exposure.

Dose in Kidney disease:

• No dosage adjustments have been provided by the manufacturer.
• However, dosage adjustment is not required because of the minimal systemic absorption.

Dose in Liver disease:

• No dosage adjustments have been provided by the manufacturer.
• However, adjustments in the dose are not required due to minimal systemic absorption.

Side Effects of Gatifloxacin Eye Drops (Zymaxid):

• Central Nervous System:

  • Headache

• Endocrine & Metabolic:

  • Chemosis

• Gastrointestinal:

  • Dysgeusia

• Ophthalmic:

  • Conjunctival Hemorrhage
  • Conjunctival Irritation
  • Conjunctivitis (Worsening)
  • Decreased Visual Acuity
  • Dry Eye Syndrome
  • Eye Discharge
  • Eye Irritation
  • Eye Pain
  • Eye Redness
  • Eyelid Edema
  • Increased Lacrimation
  • Keratitis
  • Papillary Conjunctivitis

Contraindications to Gatifloxacin Eye Drops (Zymaxid):

• Gatifloxacin, other quinolones, or any ingredient in this formulation allergy reactions

Warnings and precautions

• Hypersensitivity reactions

  • An allergic reaction to the drug can cause severe reactions, including anaphylaxis, angioedema (including angioedema in the airways, face and pharynx), shortness or itching, and urticaria.
  • One single application of topical ophthalmic may cause allergic reactions. 
  • Rarely, patients may develop severe skin reactions like the Steven-Johnson syndrome.

• Superinfection

  • Long-term use of the drug can lead to serious opportunistic infection, which may need to be stopped and treated accordingly.

Monitoring Parameters:

None mentioned. Monitor treatment response and vision in patients who have severe infections of the eyes.

How to administer Gatifloxacin Eye Drops (Zymaxid)?

• The ophthalmic solution is intended for infections of the eyes only.
• It should not be used via other routes.
• Avoid contaminating the eye drops by not touching the tip of the applicator with fingers or other surfaces.

Mechanism of action of Gatifloxacin Eye Drops (Zymaxid):

• Gatifloxacin, a bactericidal antibacterial, inhibits topoisomerase II and topoisomerase III. 
• Both enzymes are critical for DNA's superhelical structure. 
• They are required for DNA repair and replication, transcription, and transposition.

When used for Ophthalmic purposes, absorption:

• It is not quantifiable (5 ng/mL).

International Brand Names of Gatifloxacin:

• Zymaxid
• Zymar
• Agatiflox
• Aquin
• Bigaflon
• Biogat
• Fudixing
• Gaforin
• Gatibact
• Gaticin-N
• Gatif
• Gatif Forte
• Gatiflo
• Gatijem
• Gatilox
• Gatsina
• Itiflox
• Loxiget
• Microgat
• Optaglo
• Poengatif
• Tag
• Tequin
• Tymer
• Xegai
• Zequin
• Zhu Ning
• Zymar
• Zymar XD
• Zymaran
• Zymaxid

Gatifloxacin Eye Drops Brand Names in Pakistan: