Quinolones in 2005: an update

Clin Microbiol Infect. 2005 Apr;11(4):256-80. doi: 10.1111/j.1469-0691.2005.01131.x.

Abstract

Quinolones are one of the largest classes of antimicrobial agents used worldwide. This review considers the quinolones that are available currently and used widely in Europe (norfoxacin, ciprofloxacin, ofloxacin, levofloxacin and moxifloxacin) within their historical perspective, while trying to position them in the context of recent and possible future advances based on an understanding of: (1) their chemical structures and how these impact on activity and toxicity; (2) resistance mechanisms (mutations in target genes, efflux pumps); (3) their pharmacodynamic properties (AUC/MIC and Cmax/MIC ratios; mutant prevention concentration and mutant selection window); and (4) epidemiological considerations (risk of emergence of resistance, clonal spread). Their main indications are examined in relation to their advantages and drawbacks. Overall, it is concluded that these important agents should be used in an educated fashion, based on a careful balance between their ease of use and efficacy vs. the risk of emerging resistance and toxicity. However, there is now substantial evidence to support use of the most potent drug at the appropriate dose whenever this is required.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / chemistry
  • Anti-Infective Agents / pharmacology
  • Anti-Infective Agents / therapeutic use*
  • Bacteria / drug effects
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology
  • Drug Resistance, Bacterial / drug effects
  • Humans
  • Microbial Sensitivity Tests
  • Quinolones / adverse effects
  • Quinolones / chemistry
  • Quinolones / pharmacology
  • Quinolones / therapeutic use*
  • Structure-Activity Relationship

Substances

  • Anti-Infective Agents
  • Quinolones