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Fluoroquinolones: how to use (but not overuse) these antibiotics
1Division of Infectious Diseases, University of Virginia Health Sciences Center, Charlottesville.
Abstract:
The fluoroquinolone antibiotics are relatively new agents with long serum half lives, a high degree of bioavailability, and a broad spectrum of activity against many gram-negative and some gram-positive organisms. They are useful in a range of clinical settings but should not be considered as first-line treatment of many infections. Specific indications include chronic osteomyelitis caused by multiple-resistant gram-negative bacilli, chronic bacterial prostatitis refractory to other oral antibiotics, complicated urinary tract infections, and empiric therapy of suspected bacterial GI infections. Quinolones may also be considered when patients are allergic to a conventional agent, when infections are caused by multiple-resistant gram-negative bacilli, or when the toxicity of an alternate therapy is greater.
Insights
Fluoroquinolone antibiotics offer broad-spectrum activity and long half-lives for specific infections like resistant osteomyelitis and prostatitis. They are valuable alternatives when conventional treatments fail or are contraindicated due to allergies or toxicity.
Area of Science:
- Pharmacology
- Infectious Diseases
- Microbiology
Background:
- Fluoroquinolones represent a class of relatively new antibiotics.
- These agents possess long serum half-lives, high bioavailability, and broad-spectrum antimicrobial activity.
- Their activity extends against numerous gram-negative and some gram-positive organisms.
Purpose of the Study:
- To delineate the specific clinical indications for fluoroquinolone antibiotic use.
- To highlight scenarios where fluoroquinolones are particularly advantageous or necessary.
- To emphasize that fluoroquinolones are not typically first-line treatments for most infections.
Main Methods:
- Review of existing clinical guidelines and literature on fluoroquinolone usage.
- Analysis of pharmacokinetic and pharmacodynamic properties of fluoroquinolones.
- Identification of specific infection types and patient profiles where fluoroquinolones are indicated.
Main Results:
- Fluoroquinolones are indicated for chronic osteomyelitis caused by multidrug-resistant gram-negative bacilli.
- They are effective for chronic bacterial prostatitis refractory to other oral antibiotics.
- Specific uses include complicated urinary tract infections and empiric therapy for suspected bacterial gastrointestinal infections.
Conclusions:
- Fluoroquinolones serve as crucial therapeutic options for challenging infections.
- Consideration for fluoroquinolone use is warranted in cases of allergy to conventional agents.
- These antibiotics are valuable when infections involve multidrug-resistant gram-negative bacilli or when alternative therapies present higher toxicity risks.