Quinolones in the treatment of bronchopulmonary infections

The role of the new fluoroquinolones in the treatment of lower respiratory tract infections is still difficult to assess. These compounds can be successfully used in the treatment of acute exacerbations of chronic bronchitis but do not seem superior to older drugs; moreover, bacteriologic persistence and even treatment failures in infections due to Streptococcus pneumoniae can be a problem. Because of the poor activity of fluoroquinolones against S. pneumoniae, these compounds do not appear to be the first choice in the empiric treatment of community-acquired pneumonia. Ciprofloxacin is apparently valuable for the treatment of pseudomonas infections in patients with cystic fibrosis: clinical results seem comparable to those obtained with conventional intravenous treatments. More clinical experience is needed to compare the role of fluoroquinolones with that of beta-lactam and aminoglycoside antibiotics in the treatment of nosocomial gram-negative pneumonia.