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The role of fluoroquinolones in respiratory tract infections

R F Grossman1

  • 1Division of Respiratory Medicine, Mount Sinai Hospital, Toronto, Canada.

The Journal of Antimicrobial Chemotherapy
|March 4, 1998
PubMed

Insights

Quinolones are effective antibiotics for various infections, including otitis media and bronchitis. Despite some reluctance for respiratory infections, they show comparable efficacy to other treatments and are valuable for severe pneumonia and switch therapy.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Antimicrobial Therapy

Background:

  • Quinolones are widely accepted for treating infections due to favorable pharmacokinetics, high antimicrobial activity, and low side-effect incidence.
  • Despite their benefits, reluctance exists in using quinolones for respiratory tract infections due to perceived limitations against Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus.

Purpose of the Study:

  • To evaluate the efficacy and application of quinolones in treating various bacterial infections.
  • To address the reluctance in using quinolones for specific indications like respiratory tract infections and sinusitis.
  • To review the role of quinolones in managing community-acquired and hospital-acquired pneumonia.

Main Methods:

  • Review of existing literature and clinical guidelines regarding quinolone use.
  • Comparison of quinolone efficacy against other antibiotic classes (beta-lactams, cephalosporins) in different infections.
  • Analysis of quinolone application in specific conditions such as malignant external otitis, chronic otitis media, sinusitis, bronchitis, and pneumonia.

Main Results:

  • Ciprofloxacin is effective for malignant external otitis and chronic otitis media caused by Pseudomonas aeruginosa, Staphylococcus aureus, and Proteus mirabilis.
  • Quinolones demonstrate equivalent efficacy to beta-lactams and cephalosporins in acute sinusitis and acute bacterial exacerbations of chronic bronchitis.
  • Current guidelines recommend quinolones for severe community-acquired pneumonia and hospital-acquired pneumonia, often in combination therapy, and support early switch to oral fluoroquinolones.

Conclusions:

  • Quinolones are highly effective and versatile antimicrobials with a broad spectrum of activity.
  • Their use in respiratory tract infections and sinusitis is supported by evidence of efficacy comparable to standard treatments.
  • Quinolones play a crucial role in managing severe pneumonia and facilitate successful early switch therapy from parenteral to oral administration.

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