Journal of Antimicrobial Chemotherapy (2000) 45, 719-723
© 2000 The British Society for Antimicrobial Chemotherapy
Leading articles |
Minimizing quinolone resistance: are the new agents more or less likely to cause resistance?
Center for Research in Anti-Infectives and Biotechnology, Creighton University School of Medicine, Omaha, NE 68178, USA
The introduction of oral antimicrobial agents with broad-spectrum activity extending to methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and other multiply antibiotic-resistant pathogens made the fluoroquinolones an attractive choice for empirical therapy for an extensive range of conditions. As a consequence there has been heavy and indiscriminate use of these agents in some centres16 resulting in fluoroquinolone resistance emerging more rapidly than anticipated in certain pathogens, especially those that were only marginally susceptible.3,4,79 With the recent releases of more potent agents such as trovafloxacin, grepafloxacin, sparfloxacin and levofloxacin, and others under development, there is now a concern that resistance to the newer agents may also develop. Two factors will be critical in determining the rate at which resistance to these agents developsthe manner in which fluoroquinolones (old and new) are used, and whether or not there are differences between the agents in their propensity to promote the development and spread of
Prescribing behaviours and infection control
Ecologically preferred properties of fluoroquinolones
Pharmacokinetics
Potency
Dissociated fluoroquinolone resistance
Conclusion
Notes
References
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