Use of fluoroquinolones: practical considerations

The fluoroquinolone class of antibiotics has expanded the therapeutic options available for serious bacterial infections. These antibiotics have activity against a wide variety of gram-negative organisms, including Pseudomonas aeruginosa, and selected gram-positive pathogens. Fluoroquinolones are well absorbed orally and are widely distributed into most tissues and fluids. Therapeutic indications include urinary tract infections, urethral and cervical gonorrhea, traveler's diarrhea, selected gram-negative respiratory and bone infections, and certain mycobacterial infections. Because adequate concentrations of fluoroquinolones are not achieved in cerebrospinal fluid, their use should be avoided in meningitis. Cost, drug interactions, adverse effects and resistance pose problems for the clinician. Fluoroquinolones should be restricted to proven indications when less costly agents are inappropriate.