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The fluoroquinolones.

R C Walker1, A J Wright

  • 1Division of Infectious Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905.

Mayo Clinic Proceedings
|December 1, 1991
PubMed
Summary
This summary is machine-generated.

Fluoroquinolone antibiotics target bacterial DNA gyrase, showing broad-spectrum efficacy against Gram-negative bacteria. However, resistance is increasing in some bacteria, and they are contraindicated in pediatric and pregnant populations.

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Area of Science:

  • Microbiology
  • Pharmacology

Background:

  • Fluoroquinolones represent a significant class of antibiotics with mechanisms similar to beta-lactam agents.
  • They function by inhibiting bacterial DNA gyrase, leading to bactericidal effects.

Purpose of the Study:

  • To provide a comprehensive overview of the fluoroquinolone class of antibiotics.
  • To discuss their spectrum of activity, pharmacokinetic properties, and clinical considerations.

Main Methods:

  • Review of existing literature on fluoroquinolone antibiotics.
  • Analysis of their chemical structure, mechanism of action, and clinical applications.

Main Results:

  • Fluoroquinolones exhibit potent activity against most Gram-negative bacteria, with ciprofloxacin being highly effective against Pseudomonas aeruginosa.

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  • Variable activity against Gram-positive organisms is noted, with increasing resistance in methicillin-resistant Staphylococcus aureus.
  • Newer agents are expected to show enhanced activity against anaerobic bacteria, Mycobacterium, Chlamydia, and Mycoplasma.
  • Excellent oral absorption is typical, though impaired by certain supplements and antacids.
  • Cerebrospinal fluid penetration is generally inadequate, but tissue penetration is excellent.
  • Side effects are rare, but drug interactions with caffeine or theophylline can cause central nervous system toxicity.

    • Conclusions:

    • Fluoroquinolones are a promising and evolving class of antibiotics with broad applications.
    • Careful consideration of resistance patterns, drug interactions, and contraindications is essential for safe and effective use.
    • Contraindicated in children, adolescents, and pregnant/breast-feeding women due to potential cartilage development effects.