Antibacterial activity of norfloxacin

Norfloxacin, a new quinoline derivative, was studied in vitro, and determinations of agar dilution minimal inhibitory concentrations (MICs) and broth dilution MICs and MBCs were made. Nalidixic acid and cinoxacin were used as comparative agents. Norfloxacin was found to be extremely active against all strains tested of Escherichia coli, Klebsiella spp., Proteus mirabilis, indole-positive Proteus spp. Serratia spp., Citrobacter spp., and Enterobacter spp., with MICs normally below 1 microgram/ml. It also was found to be highly active against Pseudomonas aeruginosa, Staphylococcus saprophyticus, and enterococci, which are all resistant to nalidixic acid and cinoxacin. The MICs for norfloxacin obtained by broth dilution were slightly higher than those obtained by agar dilution, whereas the reverse was true for nalidixic acid and cinoxacin. The MBCs of norfloxacin were only slightly higher than the MICs, even at high inocula. The in vitro activity of norfloxacin was not dependent on the inoculum size, whereas both the MICs and the MBCs of nalidixic acid increased markedly for many of the strains tested when the inoculum was increased in broth dilution from 10(3) to 10(6) colony-forming units per ml. Norfloxacin seems to be a promising antibacterial agent for the treatment of urinary tract infections, especially those caused by Pseudomonas spp. and other species today requiring the use of injectable antibiotics.