Quinolone activity against anaerobes: microbiological aspects

Currently available quinolones are either inactive or marginally active against anaerobic bacteria. This review summarises the in vitro activity of currently available as well as experimental quinolones against clinically significant anaerobic bacteria. Quinolones with low activity against anaerobes include ciprofloxacin, ofloxacin, levofloxacin, fleroxacin, pefloxacin, enoxacin, lomefloxacin and probably E 4868 and NM 441. Compounds with intermediate anaerobe activity include sparfloxacin, grepafloxacin, PD 131628 and AM 1155. Quinolones that are very active against anaerobes include clinafloxacin and DU 6859a. CP 99,219, a naphthyridone, is also very active against anaerobes. Toxicity problems have necessitated the withdrawal of some quinolones shown to have intermediate activity (temafloxacin and tosufloxacin) and the discontinuation of the development of some investigational agents (Win 57273 and BAY Y 3118) with high activity. Conclusions regarding the therapeutic value of quinolones against human anaerobic infections await further clinical toxicological and pharmacokinetic studies.