Fluoroquinolones - A Review II

(Compiled by T R Ramanujam)
Prof Head, Department of pharmacology

Adverse effects

Drug Interactions

Pharmacological outline of Sparfloxacin

FUTURE DEVELOPMENTS of Quinolones

Conclusion

FUTURE DEVELOPMENTS of Quinolones

Recent Advances with Newer Quinolones:

1. Grepafloxacin in o/d regimen is superior to ciprofloxacin in Streptococci pneumoniae
2. Gatifloxacin o/d is highly effective in Respiratory & UTI and did not exhibit any phototoxicity.
3. Sitfloxacin useful in treatment of Catheter associated nosocomial and other infections by Pseudomonas species with less chance for resistance induction.
4. Oral Trovafloxacin is very effective against MDR respiratory pathogen because of its greater penetration into respiratory fluids and secretion.
5. Moxifloxacin is highly effective in M. catrrhalis, Chlamydiae, Mycoplasmae, Legionellae because of its 10 fold Intra Cellular concentrations on oral administration.
6. Moxifloxacin is highly active against str. peumoniae (Penicillin/macrolide resistant)
7. Newer quinolones have greater activity than macrolide or cephalosporins against common respiratory pathogens and therefore useful in;

-community acquired pneumonia

-Penicillin resistant Streptococci pneumonia

-Beta-lactamase resistant H.influenzae

-Beta-lactamase resistant Mor.catarrhalis.

H. Once /day alatrovafloxacin/Trovafloxacin IV to oral treatment is clinically effective as twice/day IV to oral ciprofloxacin for treatment of nosocomial infections with no additional anaerobic coverage.

Future Quinolones:

1. Greater potency

2. Reduced frequency of resistance selection

3· Better CNS/CSF penetration

4. Improved safety & tolerability

5. Greater activity against gram+ve species

6. Effective against IC pathogens

7. Enhanced activity against anaerobes

8. Suitable for paediatric use.