Trovafloxacin

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Image:Trovafloxacin.png
Trovafloxacin
Systematic (IUPAC) name
7-(6-amino-3-azabicyclo[3.1.0]hex-3-yl)- 1-(2,4-difluorophenyl)- 6-fluoro-4-oxo-[1,8] naphthyridine-3-carboxylic acid
Identifiers
CAS number	147059-72-1
ATC code	J01 MA13
PubChem	62959
DrugBank	APRD01281
Chemical data
Formula	C₂₀H₁₅F₃N₄O₃
Mol. weight	416.353 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status
Routes	?

Trovafloxacin (sold as Trovan® by Pfizer) is a broad spectrum antibiotic that inhibits DNA supercoiling in various bacteria by blocking the activity of DNA gyrase and topoisomerase IV [1]. It is not used widely due to the risk of hepatotoxicity. It tends to have better gram-positive bacterial coverage and less gram-negative coverage than the previous fluoroquinolones.

In 1996, during a meningitis epidemic in Kano, Nigeria, the then-untested drug was administered to approximately 100 infected children. A panel of medical experts later implicated Pfizer in the incident, concluding the drug had been administered as part of an illegal clinical trial without authorization from the Nigerian government or consent from the children's parents.<ref name = WP>Stephens, Joe. "Panel Faults Pfizer in '96 Clinical Trial In Nigeria", The Washington Post, May 7, 2006, p. A01. Retrieved on 2006-08-28.</ref> The case came to light in December 2000 as the result of an investigation by The Washington Post, and sparked significant public outcry.

When it went on the market in 1998 Trovan became one of Pfizer's top-selling drugs. When first-quarter earnings were announced in April of that year, the company's earnings had increased by 15% over the previous year, with analysts attributing much of that increase to the sales of the "new antibiotic" Trovan.<ref name = NYT1>Bloomberg News. "2 Drug Companies Report Big Quarterly Profit Gains", The New York Times, April 15, 1998, p. D.5. Retrieved on 2006-10-29. (via ProQuest, Document ID 28630468)</ref> Pfizer had spent hundreds of millions of dollars developing Trovan. In the first year it brought over US$160 million and investors expected it to eventually bring in US$1 billion per year.<ref name = NYT3>Petersen, Melody. "Unforeseen Side Effects Ruined One Blockbuster", The New York Times, August 27, 2000, p. 3.11. Retrieved on 2006-10-29. (via ProQuest, Document ID 58860021)</ref>

In June 1999 the U.S. Food and Drug Administration advised doctors to limit the prescription of Trovan after it had been found "strongly associated" with 14 cases of acute liver failure and six deaths. The FDA had received over 100 reports of liver problems in people taking Trovan, which was at that time being prescribed at a rate of 300,000 patients per month in the United States. Two days later the Committee for Proprietary Medicinal Products recommended to the European Commission that marketing approval of Trovan be suspended for a year.<ref name = NYT3>Petersen, Melody. "Unforeseen Side Effects Ruined One Blockbuster", The New York Times, August 27, 2000, p. 3.11. Retrieved on 2006-10-29. (via ProQuest, Document ID 58860021)</ref><ref name = NYT2>Reuters. "Suspension of Trovan Drug in Europe Is Urged", The New York Times, June 12, 1999, p. C.3. Retrieved on 2006-10-29. (via ProQuest, Document ID 42327418)</ref>

[edit] References

Quinolones (J01M) edit
Fluoroquinolones:	Ciprofloxacin, Enoxacin, Fleroxacin, Gatifloxacin, Gemifloxacin, Grepafloxacin, Levofloxacin, Lomefloxacin, Moxifloxacin, Norfloxacin, Ofloxacin, Pefloxacin, Prulifloxacin, Rufloxacin, Sparfloxacin, Temafloxacin, Trovafloxacin, Sitafloxacin
Other quinolones:	Cinoxacin, Flumequine, Nalidixic acid, Oxolinic acid, Pipemidic acid, Piromidic acid, Rosoxacin