The role of the fluoroquinolones.
Over the past decade, the quinolone antimicrobial class has enjoyed a renaissance with the emergence of the fluoroquinolone subclass. Norfloxacin, ciprofloxacin, ofloxacin, enoxacin, and lomefloxacin have the advantages of broad antimicrobial activity profiles including gram-positive and -negative aerobes, favorable pharmacokinetic profiles including substantial oral bioavailability and extensive tissue distribution, and in general, favorable safety profiles. As clinical experience accumulates, our understanding of their optimum roles will become more refined. In six instances, these agents may be preferred over currently available agents: complicated urinary tract infections, empiric therapy of suspected bacterial gastroenteritis, eradication of the Salmonella carrier state, respiratory exacerbations due to Pseudomonas aeruginosa in patients with cystic fibrosis, invasive external otitis, and chronic gram-negative bacillary osteomyelitis. The efficacy and convenience of these agents for the treatment of a broad range of infections have already resulted in their extensive use. Such use carries the risk of selection pressure for the development of resistance and the adverse consequences of increased cost over less expensive, equally effective alternatives. The use of the fluoroquinolones should focus on infections where there is demonstrated benefit of these agents over conventional agents or infections for which there are few or no alternatives.
Guay
D R
DR
College of Pharmacy, University of Minnesota, Minneapolis.
D000890:Anti-Infective Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D004347:Drug Interactions; D004352:Drug Resistance, Microbial; D024841:Fluoroquinolones; D005767:Gastrointestinal Diseases / Q000188:drug therapy; D006801:Humans; D008297:Male; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012749:Sexually Transmitted Diseases / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy
D000890:Anti-Infective Agents; D024841:Fluoroquinolones