The New Fluoroquinolones: A Critical Review

Zhanel, George G.; Walkty, Andrew; Vercaigne, Lavern M.; Karlowsky, James A.; Embil, John M.; Gin, Alfred S.; Hoban, Daryl J.

doi:10.1155/1999/378394

Cited by 106 publications

(56 citation statements)

References 198 publications

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“…However, moxifloxacin, which has significant anaerobic activity [8], was associated with a relatively low risk of CDAD in the analysis of Pépin et al [1]. Ciprofloxacin and levofloxacin, which have limited activity against anaerobes, were associated with much higher risks of CDAD in the analysis by Pépin et al [1], but in another study, the reintroduction of levofloxacin decreased the rate of CDAD [7].…”

Section: Acknowledgmentsmentioning

confidence: 99%

Poor Infection Control, Not Fluoroquinolones, Likely to Be Primary Cause of Clostridium difficile-Associated Diarrhea Outbreaks in Quebec

Weiss¹

2006

Clinical Infectious Diseases

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Section: Acknowledgmentsmentioning

confidence: 99%

Poor Infection Control, Not Fluoroquinolones, Likely to Be Primary Cause of Clostridium difficile-Associated Diarrhea Outbreaks in Quebec

Weiss¹

2006

Clinical Infectious Diseases

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“…Decreased susceptibility to fluoroquinolones may develop as a result of changes in the fluoroquinolone targets by mutations in the genes which encode ParC in topoisomerase IV and GyrA in DNA gyrase and/or by diminished drug accumulation by efflux (7,9,10,17,19,20). Mutations in gyrB have not to date been associated with decreased susceptibility to the fluoroquinolones in S. pneumoniae, and whether mutations in parE alter the susceptibility is still controversial (1,16,17).…”

mentioning

confidence: 99%

“…Mutations in the primary target that result in a reduction in the affinity of the fluoroquinolone are associated with an increase in the MIC. A subsequent mutation in the original secondary target will result in a further increase in the MIC (7,9,10,17,19,20). Laboratory identification of isolates with decreased susceptibility to fluoroquinolones is paramount for the effective treatment of patients with pneumococcal disease.…”

mentioning

confidence: 99%

Evaluation of Susceptibility Testing To Detect Fluoroquinolone Resistance Mechanisms in Streptococcus pneumoniae

Richardson

Bast

McGeer

et al. 2001

Antimicrob Agents Chemother

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To determine if susceptibility testing of Streptococcus pneumoniae could detect those isolates that had one of the recognized mechanisms of fluoroquinolone resistance, 101 isolates were selected; the levofloxacin MIC for 28 of these isolates was >4 g/ml. Only isolates with both parC and gyrA mutations or with no recognized resistance mechanisms were reliably identified by using these results. Isolates with only a parC mutation could not be detected reliably using any susceptibility testing method.

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“…Agents in a second group of antibiotics, including fluoroquinolones and aminoglycosides, achieve bacterial killing in a concentration-dependent manner and exhibit prolonged persistence effects [3,6,10,16•,17•, [18][19][20][21][22][23][24][25]. In vitro, animal and human studies have shown that the pharmacodynamic parameter that best correlates with bacteriological eradication is AUC 24 /MIC (Table 1) [3,6,10,16•,17•,18-22,24].…”

Section: Pharmacokinetic/pharmacodynamic Antibiotic Relationshipsmentioning

confidence: 99%

Influence of pharmacokinetic and pharmacodynamic principles on antibiotic selection

Zhanel

2001

Curr Infect Dis Rep

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When evaluating the efficacy of antibiotics for the treatment of respiratory tract infections, such as community acquired pneumonia and acute exacerbations of chronic bronchitis, assessment of clinical cure may not be the most relevant parameter, as it may not be related to microbiological eradication or to the minimum inhibitory concentration (MIC) of the infecting pathogen. It is more relevant to study the efficacy of the antibiotic in eradicating the bacterial pathogen, because this is frequently related to both the MIC of the pathogen and the antibiotic dosage regimen. Pharmacodynamics correlates the concentration of antibiotic in the blood or at the infection site with its biological effect against the organism (bacteriological eradication). For beta-lactams, the pharmacodynamic parameter that best correlates with eradication is time (T) above MIC (T > MIC); for aminoglycosides and fluoroquinolones, it is the area under the curve at 24 hours (AUC(24))-to-MIC ratio (AUC(24)/MIC). Knowledge of pharmacodynamics allows optimum use of antibiotics; in vitro models, animal models, and retrospective and prospective clinical trials have shown that the use of such knowledge optimizes bacteriological eradication and enhances patient outcome. In the future, pharmacodynamic studies will be used not only to assess optimal ways for antibiotics to eradicate resistant pathogens, but also to investigate the ability of antibiotics to prevent the development of resistance on therapy and to eradicate pathogens from colonizing sites.

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The New Fluoroquinolones: A Critical Review

Cited by 106 publications

References 198 publications

Poor Infection Control, Not Fluoroquinolones, Likely to Be Primary Cause of Clostridium difficile-Associated Diarrhea Outbreaks in Quebec

Poor Infection Control, Not Fluoroquinolones, Likely to Be Primary Cause of Clostridium difficile-Associated Diarrhea Outbreaks in Quebec

Evaluation of Susceptibility Testing To Detect Fluoroquinolone Resistance Mechanisms in Streptococcus pneumoniae

Influence of pharmacokinetic and pharmacodynamic principles on antibiotic selection

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