The intracellular penetration and activity of gemifloxacin in human polymorphonuclear leukocytes (PMN) were evaluated. Gemifloxacin reached intracellular concentrations eight times higher than extracellular concentrations. The uptake was rapid, reversible, and nonsaturable and was affected by environmental temperature, cell viability, and membrane stimuli. At therapeutic extracellular concentrations, gemifloxacin showed intracellular activity against Staphylococcus aureus.Most fluoroquinolones are able to concentrate intracellularly in human phagocytic cells and remain active against facultatively and obligately intracellular pathogens, such as mycobacteria, Legionella spp., Streptococcus pneumoniae, and Staphylococcus aureus (16). Gemifloxacin is a new fluoroquinolone which displays more potent activity than sparfloxacin against gram-positive organisms and anaerobes (5,7,10). In addition, it shows excellent in vitro activity against other respiratory pathogens, such as Chlamydia pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae (1,19). The purpose of this study was to evaluate the uptake of gemifloxacin by human polymorphonuclear leukocytes (PMN). Also evaluated were the mechanisms involved in the penetration of this agent into the PMN and its intracellular activity against S. aureus.PMN uptake of radiolabeled gemifloxacin (64.5 Ci/mg; SB Pharmaceuticals, Harlow, United Kingdom) was determined by means of a velocity gradient centrifugation technique described by Klempner and Styrt (6). PMN were incubated in Hanks balanced salt solution containing different concentrations of gemifloxacin (0.1 to 25 g/ml). After different incubation periods at 37°C (1 to 60 min), cells were separated from the extracellular solution by centrifugation through a waterimpermeable silicone oil barrier. A 10-l aliquot of the extracellular medium and the entire cell pellet were placed in 3 ml of scintillation fluid (Ready Micro; Beckman Instruments, Inc., Fullerton, Calif.) and counted in a liquid scintillation counter (model LS 1801; Beckman). The accumulation rate of gemifloxacin was calculated and expressed as a cellular-to-extracellular-concentration ratio (C/E ratio) (11). The efflux of cellassociated gemifloxacin was also studied. All assays were performed in duplicate with PMN from four different donors. Data were expressed as means Ϯ standard deviations. Differences among groups were compared by variance analysis, used to assess statistical significance at a P value of Յ0.05.The kinetics of the uptake and efflux of gemifloxacin by PMN are shown in Fig. 1. The uptake of gemifloxacin by the PMN was rapid and high. At extracellular concentrations of 2 g/ml, the C/E ratios were higher than 7 after 20 min of incubation. This value is similar to those described for ciprofloxacin, ofloxacin, levofloxacin, and sparfloxacin (2, 13, 14) and slightly lower than those described for trovafloxacin and moxifloxacin (17, 18). Reversibility of binding was rapid for gemifloxacin, with 60% of the cell-associated drug being lost after 5...