Quinolones in sexually transmitted diseases. Global experience

Area of Science:

• Microbiology
• Pharmacology
• Infectious Diseases

Background:

• The role of quinolone antibiotics in treating sexually transmitted diseases (STDs) requires further definition.
• Established quinolones demonstrate efficacy against gonorrhea, but resistance is a growing concern.
• Limited activity of most quinolones against Chlamydia trachomatis necessitates alternative treatment strategies.

Purpose of the Study:

• To review the current and emerging role of quinolones in managing various sexually transmitted infections.
• To evaluate the in vitro and in vivo efficacy of existing and novel quinolone agents.
• To assess the clinical utility of quinolones in conditions such as gonorrhea, chlamydia, bacterial vaginosis, and pelvic inflammatory disease.

Main Methods:

• Review of in vitro and in vivo studies on quinolone efficacy against common STDs.
• Analysis of clinical trial data for quinolone treatment of gonorrhea, chlamydia, and other related infections.
• Assessment of emerging resistance patterns and the potential of new quinolone agents.

Main Results:

• Established quinolones are effective against gonorrhea with single oral doses, but resistance is increasing.
• Ofloxacin is the only established quinolone reliably effective against Chlamydia trachomatis as a course of treatment.
• Sparfloxacin shows promise, and other new agents exhibit in vitro activity, pending clinical evaluation.
• Quinolones have shown disappointing results in bacterial vaginosis, while newer agents with anaerobic activity are of interest.
• Ciprofloxacin and ofloxacin are effective for chancroid, with currently insignificant resistance.
• Ofloxacin appears effective for pelvic inflammatory disease without additional anaerobic coverage.

Conclusions:

• Quinolones remain important in managing certain STDs like gonorrhea and chancroid, but resistance monitoring is crucial.
• Ofloxacin offers a valuable treatment option for Chlamydia trachomatis and pelvic inflammatory disease.
• Further research into novel quinolones and their application in STDs, particularly those with anaerobic activity, is warranted.