Moxifloxacin
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Moxifloxacin: From Bacterial Infections to Hyperamylasemia
One-Sentence Summary
Moxifloxacin is a fluoroquinolone antibiotic, originally used for bacterial infections such as pneumonia, conjunctivitis and plague. The TxGNN model predicts it may be effective for hyperamylasemia, but this rests on a model prediction alone, with 0 clinical trials and 0 publications supporting it.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Bacterial infections (streptococcal and staphylococcal infections, bacterial pneumonia, peritonitis, conjunctivitis, plague, etc.) |
| Predicted New Indication | Hyperamylasemia |
| TxGNN Prediction Score | 99.98% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 14 |
| Recommended Decision | Hold |
The Singapore registrations in the compiled data carry no approved-indication text. The original indications above come from the TxGNN knowledge graph, not from approved labelling.
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available in the data compiled for this report. Moxifloxacin is a fluoroquinolone antibacterial. Drugs in this class inhibit bacterial DNA gyrase and topoisomerase IV, and its efficacy in bacterial respiratory, intra-abdominal, eye and plague infections is established.
Hyperamylasemia is a laboratory finding, an elevated serum amylase level. It is not an infectious disease. No plausible mechanism links an antibacterial to lowering amylase, so the prediction looks like a graph-based artefact rather than a biologically grounded signal. A high score therefore should not be read as evidence of benefit.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Singapore Market Information
Moxifloxacin has 14 valid single-ingredient registrations in Singapore and none cancelled. They cover oral tablets, intravenous infusions and ophthalmic solutions. The five main ones are:
| Authorization Number | Product Name | Dosage Form |
|---|---|---|
| SIN11351P | Avelox Tablet 400 mg | Film-coated tablet |
| SIN11971P | Avelox Solution for Infusion 400 mg/250 ml | Injection |
| SIN12614P | Vigamox Ophthalmic Solution 0.5% | Solution |
| SIN15310P | Moxifloxacin Kabi Solution for Infusion 400 mg/250 ml | Infusion solution |
| SIN15579P | Moloxin Film-Coated Tablets 400 mg | Film-coated tablet |
Safety Considerations
Please refer to the package insert for key warnings and contraindications.
- Conditions flagged as contraindicated in the knowledge graph (these are graph associations, not label text):
- Cardiac: long QT syndrome (including familial), torsades de pointes, sudden cardiac arrest, heart conduction disease, myocardial ischemia, coronary artery disease.
- Nervous system and muscle: epilepsy, myasthenia gravis, other neuromuscular junction disease, peripheral neuropathy and other peripheral nervous system disease, tendinitis, periarthritis, exostosis.
- Liver, gut and metabolic: cirrhosis of the liver, drug-induced liver injury, potassium deficiency, Clostridium difficile colitis, perinatal necrotizing enterocolitis.
- Drug interactions: 100 interactions were recorded. Among the 20 reviewed, the following are rated Major:
- Corticosteroids: hydrocortisone, triamcinolone, dexamethasone, betamethasone.
- Others: bupropion, chlorpropamide.
Moderate interactions include antidiabetic agents (metformin, pioglitazone, alogliptin, canagliflozin, acarbose, albiglutide), calcium and potassium salts, famotidine, loperamide, aspirin, balsalazide and bisacodyl.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction has no supporting trials or publications and no plausible mechanism, and hyperamylasemia is a laboratory finding rather than a treatable infection. The high TxGNN score alone does not justify further investment.
To proceed, the following is needed:
- Any direct clinical or preclinical evidence that moxifloxacin lowers amylase or treats a condition causing hyperamylasemia
- Mechanism of action data and a mechanistic rationale
- Package insert warnings and contraindications for Singapore-registered products
- A review of the safety profile, especially QT prolongation, tendon and neuropathy risks, and the major corticosteroid interactions, before any new use is considered
Note: Among the other model predictions for moxifloxacin, bubonic plague has the most supporting evidence. It rests on preclinical studies (animal and in vitro models) and is a close extension of the existing plague indication, so it may be a better candidate to explore.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.