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Sparfloxacin: a review
1The Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospital, Kaleida Health, Buffalo, New York 14209, USA.
Background:
The continuing increase in the rate of penicillin and cephalosporin resistance among respiratory pathogens and of cross-resistance to macrolide antibiotics has led to the recommendation that fluoroquinolone antibiotics be used to treat high-risk patients with community-acquired pneumonia (CAP) and acute bacterial exacerbations of chronic bronchitis (ABECB).
Objective:
This review focuses on sparfloxacin, an oral fluoroquinolone, discussing its mechanism of action, activity, pharmacokinetic characteristics, safety, and efficacy in CAP and ABECB.
Methods:
Studies were identified by a MEDLINE search of the literature from 1990 to 1999, supplemented by educational materials from conferences and symposia.
Results:
Sparfloxacin is active against the major respiratory pathogens and against the atypical pathogens in pneumonia that are being reported with increasing frequency. Its long half-life permits once-daily dosing. In large trials in CAP and ABECB in which all isolates were susceptible to both comparators, sparfloxacin was found to have similar efficacy to erythromycin, cefaclor, amoxicillin, ofloxacin, and clarithromycin. Its safety profile is similar to that of the macrolides and other quinolone antimicrobial agents. Photosensitivity, nausea, and diarrhea are the most common adverse events reported in clinical trials of sparfloxacin. Its use is contraindicated in patients with QTc-interval prolongation.
Conclusion:
The increasing prevalence of beta-lactam- and macrolide-resistant bacteria in respiratory infections emphasizes the need for newer agents such as the fluoroquinolones. The choice between agents should be based on activity against the relevant respiratory pathogens in high-risk patients.
Insights
Sparfloxacin, an oral fluoroquinolone, shows efficacy and a similar safety profile to macrolides for treating community-acquired pneumonia (CAP) and acute bacterial exacerbations of chronic bronchitis (ABECB). This makes it a valuable option against resistant respiratory pathogens.
Area of Science:
- Pharmacology and Microbiology
- Infectious Diseases
- Respiratory Medicine
Background:
- Increasing resistance to penicillin, cephalosporins, and macrolides necessitates alternative treatments for respiratory infections.
- Fluoroquinolone antibiotics are recommended for high-risk patients with community-acquired pneumonia (CAP) and acute bacterial exacerbations of chronic bronchitis (ABECB).
Purpose of the Study:
- To review sparfloxacin, an oral fluoroquinolone, focusing on its mechanism of action, antimicrobial activity, pharmacokinetics, safety, and clinical efficacy.
- To evaluate sparfloxacin's role in treating CAP and ABECB, particularly in the context of rising antibiotic resistance.
Main Methods:
- Literature search of MEDLINE from 1990 to 1999.
- Inclusion of supplementary educational materials from conferences and symposia.
Main Results:
- Sparfloxacin demonstrates activity against major respiratory pathogens and atypical pneumonia pathogens.
- Its long half-life allows for once-daily dosing, improving patient compliance.
- Clinical trials indicate sparfloxacin has comparable efficacy to erythromycin, cefaclor, amoxicillin, ofloxacin, and clarithromycin in CAP and ABECB, with a similar safety profile to macrolides and other quinolones. Common adverse events include photosensitivity, nausea, and diarrhea; contraindicated in QTc prolongation.
Conclusions:
- The rise of beta-lactam and macrolide resistance in respiratory infections highlights the importance of newer agents like fluoroquinolones.
- Treatment decisions for high-risk patients should prioritize agents with proven activity against prevalent respiratory pathogens.