title: Fluoroquinolones in the management of community-acquired pneumonia in primary care.
abstract: A literature search was conducted to evaluate the pharmacokinetic and pharmacodynamic profile of the respiratory fluoroquinolones (gemifloxacin, levofloxacin and moxifloxacin) and their efficacy and safety in the management of community-acquired pneumonia (CAP). Data show that CAP is a common presentation in primary care practice, and is associated with high rates of morbidity and mortality, particularly in the elderly. Although the causative pathogens differ depending on treatment setting and patient factors, Streptococcus pneumoniae is the primary pathogen in all treatment settings. As a class, the respiratory fluoroquinolones have a very favorable pharmacokinetic and pharmacodynamic profile. Pharmacodynamic criteria suggest that moxifloxacin and gemifloxacin are more potent against S. pneumoniae, which may have the added benefit of reducing resistance selection and enhancing bacterial eradication. The respiratory fluoroquinolones are also generally well tolerated, and are first-line options for outpatient treatment of CAP in patients with comorbidities or previous antibiotic use.
authors.affiliation: Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia Health Center, P.O. Box 801337, Charlottesville, VA 22908-1337, USA. BW9G@hscmail.mcc.virginia.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Wispelwey
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Schafer
mesh_terms: D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use*; D001372:Aza Compounds / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D024841:Fluoroquinolones / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000077735:Gemifloxacin; D006801:Humans; D064704:Levofloxacin; D000077266:Moxifloxacin; D009287:Naphthyridines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D015242:Ofloxacin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D011320:Primary Health Care; D011804:Quinolines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D013296:Streptococcus pneumoniae / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D009287:Naphthyridines; D011804:Quinolines; D064704:Levofloxacin; D015242:Ofloxacin; D000077735:Gemifloxacin; D000077266:Moxifloxacin