Review of the in vitro activity of gemifloxacin against Gram-positive and Gram-negative anaerobic pathogens

Published reports on the in vitro activity of gemifloxacin mesylate (SB 265805), a new fluoronaphthyridone, against anaerobic pathogens are reviewed here. The studies used a variety of media, inocula and antimicrobial agents. Using a proposed breakpoint of 0.5 mg/L, these studies showed that gemifloxacin had generally higher potency against Gram-positive anaerobes (Clostridium perfringens, all Peptostreptococcus spp.) and fusobacteria (Fusobacterium nucleatum, Fusobacterium necrophorum) and moderate but variable potency against Gram-negative anaerobes. Bacteroides stercoris, Bacteroides tectum and many Bacteroides fragilis isolates were inhibited by concentrations of < or =0.5 mg/L, while the other species of the B. fragilis group required higher concentrations for inhibition. Species variability was evident: Porphyromonas asaccharolytica, Porphyromonas canoris, Porphyromonas gingivalis, Porphyromonas macaccae, Prevotella heparinolytica and Prevotella intermedia were susceptible to 0.5 mg/L of gemifloxacin while most other Porphyromonas and Prevotella spp. were not. These data suggest that gemifloxacin may have a clinical role in the treatment of certain dental, head and neck and pleuropulmonary infections in which Gram-positive anaerobes, fusobacteria and some Prevotella and Porphyromonas spp. may predominate.