Expanding Uses of Fluoroquinolones: Opportunities and Challenges

Editorials1 December 1998Expanding Uses of Fluoroquinolones: Opportunities and ChallengesDavid C. Hooper, MDDavid C. Hooper, MDMassachusetts General Hospital; Boston, MA 02114-2696Note: Dr. Hooper has received investigator-initiated grant support from several manufacturers of quinolone antibiotics and has served on advisory boards for other companies that make these products.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-11_Part_1-199812010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Drugs in the quinolone or related naphthyridine class have been available since the 1960s. Nalidixic acid, the first agent of the class to be used clinically, was largely limited to treatment of urinary tract infections. The mid-1980s saw the introduction of newer, more potent, fluorinated quinolones with broader spectra of activity and broader applications for treatment of bone, joint, and systemic infections and infections of the genital, gastrointestinal, and respiratory tracts [1]. Of the five fluoroquinolones introduced in the United States by 1992, ciprofloxacin and ofloxacin were most widely used because they had the greatest potency and the broadest set ...References1. Hooper DC, Wolfson JS. Fluoroquinolone antimicrobial agents. N Engl J Med. 1991; 324:384-94. Google Scholar2. Hooper DC, Wolfson JS. Norfloxacin, ciprofloxacin, and ofloxacin: current clinical roles. Curr Clin Top Infect Dis. 1989; 10:194-240. Google Scholar3. Two new fluoroquinolones [Letter]. Med Lett Drugs Ther. 1992; 34:58-60. Google Scholar4. Grepafloxacin-a new fluoroquinolone [Letter]. Med Lett Drugs Ther. 1998; 40:17-8. Google Scholar5. Trovafloxacin [Letter]. Med Lett Drugs Ther. 1998; 40:30-1. Google Scholar6. 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Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA. 1997; 278:901-4. Google Scholar15. Solomkin JS, Reinhart HH, Dellinger EP, Bohnen JM, Rotstein OD, Vogel SB, et al. Results of a randomized trial comparing sequential intravenous/oral treatment with ciprofloxacin plus metronidazole to imipenem/cilastatin for intra-abdominal infections. The Intra-Abdominal Infection Study Group. Ann Surg. 1996; 223:303-15. Google Scholar16. Blumberg HM, Rimland D, Carroll DJ, Terry P, Wachsmuth IK. Rapid development of ciprofloxacin resistance in methicillin-susceptible and -resistant Staphylococcus aureus. J Infect Dis. 1991; 163:1279-85. Google Scholar17. Carratala J, Fernandez-Sevilla A, Tubau F, Dominguez MA, Gudiol F. Emergence of fluoroquinolone-resistant Escherichia coli in fecal flora of cancer patients receiving norfloxacin prophylaxis. Antimicrob Agents Chemother. 1996; 40:503-5. Google Scholar18. Dudley MN. Pharmacodynamics and pharmacokinetics of antibiotics with special reference to the fluoroquinolones. Am J Med. 1991; 91:45S-50S. Google Scholar19. Hooper DC, Wolfson JS. Mechanisms of bacterial resistance to quinolones. In: Hooper DC, Wolfson JS, eds. Quinolone Antimicrobial Agents. 2d ed. Washington, DC: American Society for Microbiology; 1993; 97-118. Google Scholar20. Low DE, Scheld WM. Strategies for stemming the tide of antimicrobial resistance [Editorial]. JAMA. 1998; 279:394-5. Google Scholar Author, Article, and Disclosure InformationAuthors: David C. Hooper, MDAffiliations: Massachusetts General Hospital; Boston, MA 02114-2696Note: Dr. Hooper has received investigator-initiated grant support from several manufacturers of quinolone antibiotics and has served on advisory boards for other companies that make these products.Corresponding Author: David C. 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Kuehnert, MD, Frederick S. Nolte, PhD, and Carl A. Perlino, MDTreatment options for resistant pneumococcal infectionsDecreased Susceptibility of Streptococcus pneumoniae to Fluoroquinolones in Canada 1 December 1998Volume 129, Issue 11_Part_1Page: 908-910KeywordsAntibioticsAttentionBacterial pneumoniaDrugsPathogensPenicillinPneumoniaRespiratory system proceduresStreptococcusUpper respiratory tract infections ePublished: 15 August 2000 Issue Published: 1 December 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...