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Resistance to ciprofloxacin and the new fluoroquinolones
1Division of Microbiology, School of Biochemistry and Molecular Biology, University of Leeds, UK. p.m.hawkey@leeds.aol.uk
Abstract:
Resistance to ciprofloxacin has generally remained low in the UK. A low rate of resistance development in vitro has been suggested for the newer fluoroquinolones such as grepafloxacin and trovafloxacin. Levofloxacin is likely to have a pattern of development of resistance similar to that of ofloxacin. Resistance problems with ofloxacin are being reported in the USA, but it is unclear whether similar problems will arise with levofloxacin. Restrained quinolone use, surveillance of pathogen susceptibility and control of cross-infection with resistant clones remain important strategies for managing fluoroquinolone resistance.
Insights
Ciprofloxacin resistance remains low in the UK. Newer fluoroquinolones show low resistance development, but levofloxacin may mirror ofloxacin resistance issues, necessitating careful management strategies.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Ciprofloxacin resistance has been consistently low in the United Kingdom.
- Emerging fluoroquinolones like grepafloxacin and trovafloxacin exhibit low in vitro resistance development.
- Levofloxacin's resistance patterns are anticipated to resemble those of ofloxacin.
Purpose of the Study:
- To evaluate the current status of fluoroquinolone resistance in the UK.
- To predict the potential for resistance development with newer fluoroquinolones, specifically levofloxacin.
- To highlight strategies for managing fluoroquinolone resistance.
Main Methods:
- Review of existing data on fluoroquinolone resistance trends.
- In vitro studies on resistance development for newer agents.
- Comparative analysis of resistance patterns between related fluoroquinolones.
Main Results:
- Generally low resistance rates observed for ciprofloxacin in the UK.
- Newer fluoroquinolones demonstrate a low propensity for in vitro resistance.
- Potential for levofloxacin to exhibit resistance patterns similar to ofloxacin, with reported issues in the USA.
Conclusions:
- Continued surveillance of pathogen susceptibility is crucial.
- Judicious use of quinolones and control of cross-infection are vital strategies.
- Proactive management is necessary to mitigate rising fluoroquinolone resistance.