Fluoroquinolone antibiotics (ciprofloxacin and moxifloxacin)
To date, there are two studies published investigating the effect of
bariatric surgery on oral fluoroquinolone antibiotics.
De Smet and colleagues studied the oral bioavailability of moxifloxacin
in 12 individuals after RYGB surgery 51. Each subject
received two single doses of 400 mg oral or intravenous moxifloxacin
with a washout period of seven days at least six months after surgery.
While mean oral bioavailability was 88%, oral and intravenous exposures
were 50% higher than those described for subjects without gastric
bypass 51. The authors suggest that differences in
percentage man/women or a higher enterohepatic recirculation of
moxifloxacin after gastric bypass may contribute to this finding.
Rivas et al. evaluated the pharmacokinetic parameters of ciprofloxacin
in 17 RYGB patients before, one month, and six months after surgery
compared to 17 matched controls 52. AUC was 9737.2 ±
2717.6 h.ng/ml in the control and 9141.3 ± 1774.0 h.ng/ml at baseline in
the surgery group. One month after surgery, AUC decreased to 7581.4 ±
1511.1 h.ng/ml and returned to presurgical baseline values at 6 months
after surgery (9067.6 ± 3880.2 h.ng/ml).