1: Clin Microbiol Infect. 2005 Apr;11(4):256-80. 

Quinolones in 2005: an update.

Van Bambeke F, Michot JM, Van Eldere J, Tulkens PM.

Unit of Cellular and Molecular Pharmacology, Catholic University of Louvain,
Brussels. vanbambeke@facm.ucl.ac.be

Quinolones are one of the largest classes of antimicrobial agents used
worldwide. This review considers the quinolones that are available currently and
used widely in Europe (norfoxacin, ciprofloxacin, ofloxacin, levofloxacin and
moxifloxacin) within their historical perspective, while trying to position them
in the context of recent and possible future advances based on an understanding
of: (1) their chemical structures and how these impact on activity and toxicity;
(2) resistance mechanisms (mutations in target genes, efflux pumps); (3) their
pharmacodynamic properties (AUC/MIC and Cmax/MIC ratios; mutant prevention
concentration and mutant selection window); and (4) epidemiological
considerations (risk of emergence of resistance, clonal spread). Their main
indications are examined in relation to their advantages and drawbacks. Overall,
it is concluded that these important agents should be used in an educated
fashion, based on a careful balance between their ease of use and efficacy vs.
the risk of emerging resistance and toxicity. However, there is now substantial
evidence to support use of the most potent drug at the appropriate dose whenever
this is required.

PMID: 15760423 [PubMed - in process]