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Quinolones: clinical use and formulary considerations
1Infectious Disease Division, Winthrop-University Hospital, Mineola, New York 11501, USA.
Advances in Therapy
|May 27, 1999
Summary
Levofloxacin is the preferred quinolone antibiotic due to its broad-spectrum activity, minimal side effects, and low resistance potential. It offers a versatile and cost-effective option for various infections.
Area of Science:
- Pharmacology
- Microbiology
- Infectious Diseases
Background:
- Quinolones are broad-spectrum antibiotics primarily targeting aerobic gram-negative bacteria.
- Specific quinolones exhibit varying activity against oral anaerobes and atypical pulmonary pathogens.
- Antibiotic selection involves balancing microbiologic activity, safety, and cost.
Purpose of the Study:
- To compare the efficacy, safety, and resistance profiles of various quinolone antibiotics.
- To identify the most suitable quinolone for general use based on comprehensive evaluation.
Main Methods:
- Comparative analysis of quinolone activity against aerobic gram-negative organisms, oral anaerobes, and atypical pulmonary pathogens.
- Evaluation of safety profiles, including central nervous system side effects, photosensitivity, and gastrointestinal issues.
- Assessment of resistance potential and cost-effectiveness of different quinolones.
Main Results:
- Trovafloxacin offers coverage against Bacteroides fragilis but has the least activity against Chlamydia and the most adverse reactions.
- Ciprofloxacin and trovafloxacin are associated with central nervous system side effects; sparfloxacin with photosensitivity.
- Levofloxacin demonstrates the lowest resistance potential and is the least expensive parenteral option.
Conclusions:
- Levofloxacin is recommended for general use due to its favorable safety profile, minimal resistance development, and cost-effectiveness.
- The versatility and comprehensive benefits of levofloxacin make it a preferred choice for monotherapy or combination treatment.