[Fluoroquinolones, 10 years later]

During the last few years the fluoroquinolone class has been profoundly reshaped. The development of mutation-acquired resistance, principally from staphylococci and Gram-negative bacteria responsible for nosocomial infections has restricted the use of these antibiotics as first-line monotherapy to some community-acquired infections (urinary tract, gastrointestinal, sexually transmitted infections), while defects in their antibacterial spectrum (pneumococci, streptococci and anaerobes) have reduced the possibility of use against respiratory infections. Future developments concern compounds that are active against Gram-positive cocci and some intracellular bacteria (e.g. mycobacteria) and possibly against certain parasites. Problems of tolerance are important in clinical trials of the new compounds.