Perspectives on newer oral antimicrobials: what do they add?

Since oral antimicrobials have been commercially available, the few select compounds of the 1950s have evolved into an array of choices from the multiple classes currently approved for human use. This proliferation resulted primarily from the need for extended spectrum antimicrobials because of changing resistance patterns among established pathogens and emergence of new pathogens. However, it is not clear that newer oral cephalosporins, fluoroquinolones or macrolides necessarily provide clear advantages over existing drugs for many common or routine infections. Other goals of new drug development include minimizing adverse events and improving convenience. The dilemma facing clinicians is when to use these new or soon to be released compounds. This presentation addresses these and other questions as the elusive search for the ideal oral antimicrobial continues.