The fluoroquinolone class of antibiotics promises to become as diverse and as important
as β-lactam agents. The fluoroquinolones inhibit bacterial DNA gyrase and are bactericidal.
All fluoroquinolones have potent activity against most gram-negative bacteria; ciprofloxacin
is the most active against Pseudomonas aeruginosa. Activity against gram-positive organisms is variable; methicillin-resistant Staphylococcus aureus has acquired resistance to the fluoroquinolones at an alarming rate. Currently available
quinolones do not have, but new quinolone agents likely will have, substantial activity
against anaerobic bacteria. Some quinolones are also active against Mycobacterium, Chlamydia, and Mycoplasma organisms. All fluoroquinolones have excellent absorption after oral administration;
however, this process can be impaired by the presence of aluminum- or magnesium-containing
antacids and by zinc, iron, or calcium supplements. Ciprofloxacin is also available
for intravenous use. Although most fluoroquinolones do not achieve adequate cerebrospinal
fluid levels, penetration into other tissues is excellent. Dosage adjustments for
renal and hepatic dysfunction vary among the quinolones. Although side effects are
rare, concomitant use of caffeine or theophylline with some quinolones may cause toxicity
to the central nervous system. Because they may affect the development of cartilage,
all fluoroquinolones are contraindicated in children, adolescents, and pregnant or
breast-feeding women.
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Footnotes
Individual reprints of this article are not available. The entire Symposium on Antimicrobial Agents will be available for purchase as a bound booklet from the Proceedings Circulation Office at a later date.
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© 1991 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
