The fluoroquinolones as treatment for infections caused by gram-positive bacteria. 1994

M Cruciani, and D Bassetti
Istituto di Immunologia e Malattie Infettive, Universita di Verona, Ospedale Civile Maggiore, Italy.

The fluoroquinolones have become attractive options as treatment for a broad range of infections caused by Gram-negative bacteria. However, the value of these antibiotics to patients with infections caused by Gram-positive pathogens remains controversial. Experience with quinolones as therapy for skin and skin structure infections, osteomyelitis and peritonitis in patients receiving continuous ambulatory peritoneal dialysis suggests that the concerns which have been expressed about the use of these agents against methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis and streptococci are justified; indeed, the frequent emergence of quinolone-resistant strains of MRSA and coagulase-negative staphylococci either during or following treatment is now well documented. The fluoroquinolones should be prescribed with caution to patients with community-acquired pneumonia or whenever severe infection of pneumococcal aetiology is proven or suspected. As prophylaxis for the granulocytopenic patient, quinolones such as norfloxacin and ciprofloxacin have been shown to be effective in reducing the incidence of morbidity attributable to Gram-negative bacteria, but they have not significantly affected the incidence of infection caused by Gram-positive bacteria. In the treatment of febrile episodes in the neutropenic patient, ciprofloxacin, the quinolone investigated most extensively in this clinical setting, produced high cure rates only when it was combined with an antibiotic which was predictably active against Gram-positive organisms. We review here the role of currently-available fluoroquinolones (norfloxacin, enoxacin, pefloxacin, ofloxacin and ciprofloxacin) as treatment for these and other infections.

UI MeSH Term Description Entries
D010019 Osteomyelitis INFLAMMATION of the bone as a result of infection. It may be caused by a variety of infectious agents, especially pyogenic (PUS - producing) BACTERIA. Osteomyelitides
D010538 Peritonitis INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs. Primary Peritonitis,Secondary Peritonitis,Peritonitis, Primary,Peritonitis, Secondary
D004697 Endocarditis, Bacterial Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use. Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000380 Agranulocytosis A decrease in the number of GRANULOCYTES; (BASOPHILS; EOSINOPHILS; and NEUTROPHILS). Granulocytopenia,Agranulocytoses,Granulocytopenias
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D012874 Skin Diseases, Infectious Skin diseases caused by bacteria, fungi, parasites, or viruses. Infectious Skin Diseases,Disease, Infectious Skin,Diseases, Infectious Skin,Infectious Skin Disease,Skin Disease, Infectious
D016908 Gram-Positive Bacterial Infections Infections caused by bacteria that retain the crystal violet stain (positive) when treated by the gram-staining method. Bacterial Infections, Gram-Positive,Infections, Gram-Positive Bacterial,Bacterial Infection, Gram-Positive,Bacterial Infections, Gram Positive,Gram Positive Bacterial Infections,Gram-Positive Bacterial Infection,Infection, Gram-Positive Bacterial,Infections, Gram Positive Bacterial
D024841 Fluoroquinolones A group of QUINOLONES with at least one fluorine atom and a piperazinyl group. Fluoroquinolone

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