Journal of Antimicrobial Chemotherapy (1999) 44, 425-427
© 1999 The British Society for Antimicrobial Chemotherapy
Leading article |
Will pneumococci put quinolones in their place?
Public Health and Clinical Microbiology Laboratory, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK
Quinolone antibiotics were first introduced into clinical practice in the early 1960s. The original quinolone, nalidixic acid, had limited use due to low intrinsic activity and the rapid development of bacterial resistance. Addition of fluorine to the quinolone molecule expanded the spectrum of activity of quinolones, as exemplified by ciprofloxacin, which was introduced in 1987. However, whilst ciprofloxacin has a broad spectrum of activity against Gram-negative bacteria, it has less activity against Gram-positive bacteria, particularly Streptococcus pneumoniae.
Further manipulation of the quinolone nucleus has led to the development of newer
quinolones with enhanced activity in vitro against S. pneumoniae and
this, together with their other spectrum of activity, is being used to justify their use as empirical
monotherapy in the treatment of respiratory tract infections. Of these newer quinolones,
grepafloxacin, sparfloxacin, levofloxacin, moxifloxacin and trovafloxacin are currently, or
shortly
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