Is more than one quinolone needed in clinical practice?

Area of Science:

• Pharmacology
• Infectious Diseases
• Antimicrobial Therapy

Background:

• Fluoroquinolones represent a potent class of broad-spectrum antimicrobial agents available in oral and intravenous formulations.
• These antimicrobials are utilized for a diverse array of community-acquired and nosocomial infections.
• The increasing number of available fluoroquinolones necessitates clear differentiation for effective clinical application.

Purpose of the Study:

• To review clinical information on fluoroquinolone antimicrobials.
• To distinguish between different fluoroquinolone agents.
• To define the optimal place of fluoroquinolones in clinical practice.

Main Methods:

• Identification of primary and review articles on fluoroquinolones commercially available in the US by August 2000 via MEDLINE and secondary sources.
• Inclusion of pertinent published clinical trials for levofloxacin, moxifloxacin, and gatifloxacin.
• Inclusion of minimal data for quinolones with restricted uses (e.g., trovafloxacin, sparfloxacin) and selective inclusion of ciprofloxacin trials.

Main Results:

• Fluoroquinolones are potent broad-spectrum antimicrobial agents for various infections.
• Over ten quinolones have been approved, with some withdrawn and others under investigation.
• Differentiation between fluoroquinolone agents is increasingly important due to evolving usage and availability.

Conclusions:

• Variations in safety profiles among fluoroquinolones are significant.
• Differences in antimicrobial spectrum of activity necessitate tailored prescribing.
• Understanding resistance development is crucial for the selective use of fluoroquinolones in specific clinical scenarios.