Is more than one quinolone needed in clinical practice?
OBJECTIVE
To review clinical information on fluoroquinolone antimicrobials to distinguish between these agents and help define their place in clinical practice.


METHODS
Primary and review articles on fluoroquinolones available commercially in the US as of August 2000 were identified through MEDLINE (from 1993-August 2000) and secondary sources.


METHODS
All pertinent, published, clinical trials for levofloxacin, moxifloxacin, and gatifloxacin were included. Minimal data were included for quinolones with restricted or limited uses, including trovafloxacin, sparfloxacin, enoxacin, and lomefloxacin. Due to the quantity of data on ciprofloxacin, only more recent or pivotal trials or articles summarizing data on specific infections were included. Relevant information was included if it was believed to assist in differentiating between the fluoroquinolones for infections for which these agents would most commonly be considered.


RESULTS
Fluoroquinolones are a potent class of intravenous and oral broad-spectrum antimicrobial agents used for treating a wide range of community-acquired and nosocomial infections. More than 10 quinolones have been approved for use; although some of these have been withdrawn from the market, numerous others are under investigation. It has become increasingly important to be able to differentiate between these agents.


CONCLUSIONS
Differences in safety, antimicrobial spectrum of activity, and resistance development support the selective use of various fluoroquinolones in differing clinical situations.
Paladino
J A
JA
Clinical Outcomes & Pharmacoeconomics, CPL Associates, Amherst, NY 14226-1727, USA. drjoepal@earthlink.net
D000890:Anti-Infective Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D024841:Fluoroquinolones; D006207:Half-Life; D006801:Humans; D007408:Intestinal Absorption; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D014018:Tissue Distribution
D000890:Anti-Infective Agents; D024841:Fluoroquinolones