Fluoroquinolone Antibiotics

Since the introduction of ciprofloxacin in 1987, fluoroquinolones have expanded far beyond their early role in the treatment of urinary tract infections. Clinical applications beyond genitourinary tract infections include upper and lower respiratory infections, gastrointestinal infections, gynecologic infec tions, sexually transmitted diseases, and some skin and soft tissue infections. Their ease of administration, favorable pharmacokinetic properties, excellent tolerability, and efficacy give them enormous potential for use and misuse alike. Quinolones have few common adverse effects, most notably nausea, headache and dizziness. Less frequent but more serious adverse events include prolongation of the corrected QT interval, phototoxicity, liver enzyme abnor malities, arthropathy, and cartilage and tendon abnormalities. While possess ing many of the favorable properties of intravenous agents, most fluoro quinolones offer the convenience of oral administration, thus contributing to decreased health-care costs through increased outpatient therapy and short ened hospital stays. With the recent introduction of agents such as gatifloxacin and moxifloxacin, the traditional Gram-negative coverage of fluoroquinolones has been expanded to include Gram-positive organisms, most importantly Streptococcus pneumoniae.

Klappentext

The quinolones are making a significant contribution to patient care and have added a new dimension to antibacterial therapy. During the last decade, they became important agents for treating hospital-acquired infections. This volume covers their mechanisms of action, resistance mechanisms and epidemiology, pharmacokinetics, safety and clinical applications. Their effectiveness for respiratory, urinary, sexually transmitted, skin, soft tissue, bone and joint infections, infections of the eyes, ears, nose and throat, and less common infections such as mycobacterial, Brucella and others are reviewed. Also described is their use in pediatric, oncology and immunocompromised patients. The quinolone story continues to be intriguing with exciting future implications.This monograph is an important comprehensive review and update for researchers and clinicians in pharmacology, clinical medicine, molecular and cell biology, epidemiology and the pharmaceutical industry.

Inhalt
The history of quinolones.- Structure-activity relationships of quinolones.- Epidemiology and mechanisms of resistance.- Improved safety profile of newer fluoroquinolones.- Pharmacokinetics and pharmacodynamics (PK/PD) of fluoro-quinolones: tools for combating bacteria and preventing resistance.- Fluoroquinolones in urinary tract infection.- The quinolones and sexually transmitted infections.- Gastrointestinal and intraabdominal infections.- The quinolones in otitis media and upper respiratory infections.- Quinolones in pneumonia.- Fluoroquinolones for the treatment of respiratory tractinfections other than pneumonia.- Quinolones for the treatment of skin, soft tissue, bone andprosthetic joint infections.- The role of fluoroquinolones in the therapy and prophylaxisof neutropenic patients with cancer.- Less usual indications: Mycobacterial, Brucella, Yersinia,Francisella and other infections.- The quinolones: future prospects.