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Quinolone therapy in intensive care unit settings
1Buffalo Veterans Administration Medical Center, State University of New York at Buffalo 14215.
New Horizons (Baltimore, Md.)
|May 1, 1993
Summary
Fluoroquinolones like norfloxacin, ciprofloxacin, and ofloxacin are effective against Gram-negative bacteria in ICUs. They are recommended for treating specific infections but not for selective decontamination protocols.
Area of Science:
- Pharmacology
- Infectious Diseases
- Critical Care Medicine
Background:
- Intensive care unit (ICU) patients are susceptible to Gram-negative bacterial infections.
- Fluoroquinolones are a class of antimicrobials with activity against these pathogens.
Observation:
- Norfloxacin, ciprofloxacin, and ofloxacin are key fluoroquinolones with unique pharmacokinetic profiles.
- Ciprofloxacin and ofloxacin offer intravenous administration options.
- These agents exhibit potent activity against Gram-negative aerobic bacteria.
Findings:
- Fluoroquinolones are not recommended for selective decontamination protocols.
- Endorsed for empiric therapy of suspected Gram-negative infections, guided by local susceptibility data.
- Recommended for treating documented infections due to favorable distribution, low toxicity, and rapid bactericidal action.
Implications:
- Optimizing fluoroquinolone use in ICUs requires consideration of specific infection types and bacterial resistance patterns.
- Intravenous formulations of ciprofloxacin and ofloxacin enhance treatment flexibility in critically ill patients.
- Evidence supports fluoroquinolones as valuable agents for managing serious Gram-negative bacterial infections in the ICU setting.