Fluoroquinolones.
Hendershot EF
Infectious Disease Clinics of North America. 1995 Sep;9:71530: Issue: 3
Since the introduction of the floroquinolones for clinical use in the late 1980s, they
have been used successfully for a large number of clinical situations. Unfortunately, two
of the pathogens for which these agents were most promisingmethicillinresistant
S. aureus and P. aeruginosahave developed resistance. Currently, the
quinolones are excellent agents for the treatment of complicated urinary tract infections,
including those caused by P. aeruginosa. In addition, they should be considered as initial
therapy for the treatment of severe bacterial gastroenteritis. The quinolones
should also be considered when attempting to eradicate the chronic stool carriage
of S. typhi. These agents also offer significant advantages in the treatment of
osteomyelitis and prostatitis caused by gramnegative bacilli that frequently require
prolonged antimicrobial therapy. Treatment of STDs, especially gonorrhea, is another clear
indication for their use. Ciprofloxacin should be considered as initial therapy in
patients with malignant otitis externa and in cystic fibrosis patients with exacerbations
secondary to P. aeruginosa in the sputum. The role of the quinolones for soft
tissue and respiratory tract infections is less clear and their use probably should be
limited. The new quinolones, fleroxacin, perfloxacin, sparfloxacin, and tosufloxacin,
which are being developed and tested for clinical use, will offer advantages in onceaday
dosing and better grampositive antimicrobial activity.