Quinolones in the treatment of serious infections

The new 4-quinolones have excellent broad-spectrum antibacterial activity. Pharmacokinetic studies show that they are reliably absorbed when given orally and reach high tissue levels. They are effective in animal models of systemic infections, with activity comparable to that of current antimicrobial regimens. Their use to date in systemic infections in humans has not been extensive, but results in the treatment of severe infections, including bacteremia, osteomyelitis, and pneumonia have been encouraging. The few comparative studies that have been undertaken confirm the efficacy of these agents. The limited experience with these drugs in the treatment of infection in the immunosuppressed host is largely favorable. Emergence of resistance, although demonstrable in vitro, does not appear to pose a clinical problem, although addition of a second agent may be advantageous. These drugs appear to be well tolerated, with gastrointestinal disturbance being the most commonly reported adverse effect.