Use of fluoroquinolones in lower respiratory tract infections (LRTI)

In view of their antimicrobial activity and pharmacological properties, fluoroquinolens should be suitable for the treatment of lower respiratory tract infections - specially of Gram-negative bacterial etiology. These drugs have been studied extensively in animal models of respiratory tract infections and found to be as efficacious as the comparative drugs - mostly modern betalactam antibiotics. In patients, a number of well-controlled randomized studies in lower respiratory tract infections (LRT) have been published comparing standard treatments (aminopenicillins, tetracyclines, etc.) with new fluoroquinolones. In general, the rates of cure and improvement ranged between 82% and 89% for enoxacin, ciprofloxacin, ofloxacin and pefloxacin. Fleroxacin has been studied in three clinical studied in the treatment of LRTI. It showed the same efficacy as the comparators (amoxicillin, ceftazidine) in the treatment of Gram-negative LRTI; tolerance data in these studies showed higher incidence of adverse events in the fleroxacin group versus the amoxicillin group and similar incidence of adverse events in the fleroxacin group versus the ceftazidine group. The numbers of premature treatment-withdrawal were low and not significantly different.