Fourth-generation fluoroquinolones: new topical agents in the war on ocular bacterial infections.
OBJECTIVE
The fourth-generation fluoroquinolones, moxifloxacin and gatifloxacin, were introduced in 2003 promising improved spectrum of activity and delayed development of resistance. Although these topical agents have recently been introduced in commercial form, there is already a growing body of evidence showing excellent potency in the war on ocular infections. The purpose of this review is to discuss the literature to date regarding these two agents.


RESULTS
Since their introduction in 1990 in the United States, fluoroquinolones have rapidly become the standard of care in the topical antibiotic arena. Unfortunately, recent evidence has shown the widespread use of fluoroquinolones, not only in eye care, but also in agriculture, and general medical and surgical use, has lead to decreasing susceptibilities of important ocular bacterial pathogens. Moxifloxacin and gatifloxacin have improved potency and are able to overcome resistant isolates. These agents also provide improved penetration into ocular tissues.


CONCLUSIONS
Moxifloxacin and gatifloxacin offer improved spectrum of activity, increased penetration into ocular tissues, and delayed propensity to the development of bacterial antibiotic resistance.
Mah
Francis S
FS
Department of Ophthalmology, University of Pittsburgh School of Medicine, The UPMC Eye Center Co-Medical Director, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. mahfs@upmc.edu
D000287:Administration, Topical; D001372:Aza Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D015817:Eye Infections / Q000188:drug therapy*; D024841:Fluoroquinolones / Q000008:administration & dosage* / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use; D000077734:Gatifloxacin; D006801:Humans; D000077266:Moxifloxacin; D011804:Quinolines / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use
D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077734:Gatifloxacin; D000077266:Moxifloxacin