Gatifloxacin, gemifloxacin, and moxifloxacin: the role of 3 newer fluoroquinolones.
Gatifloxacin, gemifloxacin, and moxifloxacin are the newest fluoroquinolones and show excellent in vitro activity against a wide variety of respiratory tract pathogens, many gram-negative aerobic organisms, and Bacteroides fragilis. These agents may be administered as oral and/or intravenous formulations with excellent bioavailability. The pharmacodynamics of these 3 new fluoroquinolones is more favorable than that of levofloxacin or ciprofloxacin for Streptococcus pneumoniae. All 3 agents are approved for the treatment of acute exacerbation of chronic bronchitis and community-acquired pneumonia. In addition, gatifloxacin and moxifloxacin are approved for the treatment of sinusitis. The toxicity of these 3 agents appears to be similar to that of the other fluoroquinolones in terms of gastrointestinal and central nervous system disturbances. All 3 agents have a low risk of phototoxicity, but gemifloxacin is associated with an increased risk of skin rash that is not a photoreaction. These agents can be useful for treatment of bacterial respiratory tract infections in patients who are allergic to beta-lactams, but caution must be exercised to avoid the potential for selection of widespread resistance, which may occur with indiscriminate use.
Saravolatz
Louis D
LD
Department of Medicine, St. John Hospital and Medical Center and Wayne State University School of Medicine, Detroit, Michigan 48236, USA. louis.saravolatz@stjohn.org
Leggett
James
J
D001372:Aza Compounds / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D001441:Bacteroides fragilis / Q000187:drug effects; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology*; D000077734:Gatifloxacin; D000077735:Gemifloxacin; D006801:Humans; D064704:Levofloxacin; D008826:Microbial Sensitivity Tests; D000077266:Moxifloxacin; D009287:Naphthyridines / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D015242:Ofloxacin / Q000494:pharmacology; D011804:Quinolines / Q000737:chemistry / Q000493:pharmacokinetics / Q000494:pharmacology; D013296:Streptococcus pneumoniae / Q000187:drug effects*
D001372:Aza Compounds; D024841:Fluoroquinolones; D009287:Naphthyridines; D011804:Quinolines; D002939:Ciprofloxacin; D064704:Levofloxacin; D015242:Ofloxacin; D000077734:Gatifloxacin; D000077735:Gemifloxacin; D000077266:Moxifloxacin