All topical ophthalmic fluoroquinolones are approved for patients 1 year of age and older EXCEPT which drug?

• A. Moxifloxacin
• B. Ciprofloxacin
• C. Gatifloxacin
• D. Levofloxacin

Answer: (D)

Understanding age approvals for eye antibiotics is key. Most topical fluoroquinolones have FDA labeling that allows use in children 1 year of age and older, meaning they’ve been studied and deemed safe and effective enough for pediatric patients. Moxifloxacin, ciprofloxacin, and gatifloxacin all have such pediatric approvals and are commonly used in kids for conjunctivitis and other ocular infections.

Levofloxacin ophthalmic solution, however, does not have approved pediatric labeling; its use is restricted to adults. This difference in approved age groups makes it the exception. In other words, the other three drugs can be used in children 1 year and older, while levofloxacin is not approved for that age group based on current labeling.