Management of fluoroquinolone use to avoid microbial resistance in clinical practice.
The fluoroquinolones are an important antimicrobial agent class that has been embraced by physicians and surgeons to the point that resistance in some bacterial strains has compromised their effectiveness. In some areas, pathogens such as Pseudomonas aeruginosa, Escherichia coli, Streptococcus pneumoniae, Neisseria gonorrhoeae, and Staphylococcus aureus have developed resistance to many of the fluoroquinolones. Such resistance has prompted researchers to seek new ways of using antimicrobials so that when novel drugs are developed, their useful life span is prolonged. Useful approaches for fluoroquinolone agents are to prescribe them only to patients who really need them, use newer fluoroquinolones with enhanced potency instead of older compounds with less activity, and perhaps use combinations of antimicrobials for their increased coverage and/or synergistic effect. Evidence based on past experience strongly suggests that practitioners can limit further loss of activity and ensure that this important drug class will not become prematurely ineffective.
Peterson
L R
LR
Northwestern Prevention EpiCenter, Northwestern Memorial Hospital, 251 E Huron Street, Chicago, IL 60611, USA. lancer@northwestern.edu
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000502:physiology*; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D010818:Practice Patterns, Physicians'; D013296:Streptococcus pneumoniae / Q000187:drug effects
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones