Quinolone therapy in intensive care unit settings

Three fluoroquinolone antimicrobials (norfloxacin, ciprofloxacin, and ofloxacin) could be used to prevent or treat infections in intensive care unit patients. All of these fluoroquinolones are particularly active against Gram-negative, aerobic bacteria. However, the pharmacokinetic properties of each fluoroquinolone are unique. Furthermore, only ciprofloxacin and ofloxacin are available for intravenous administration. Based on current, available information: a) fluoroquinolones are not endorsed for inclusion in selective decontamination protocols; b) fluoroquinolones are endorsed for empiric therapy of suspected Gram-negative bacterial infections based on local microorganism susceptibility patterns; and c) fluoroquinolones are endorsed for treatment of microbiologically documented infections based on their distribution properties, low rate of toxicity, and rapid bactericidal effect.