JAC Advance Access originally published online on February 24, 2005
Journal of Antimicrobial Chemotherapy 2005 55(4):511-517; doi:10.1093/jac/dki059
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Comparative activity of quinolones (ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin) against extracellular and intracellular infection by Listeria monocytogenes and Staphylococcus aureus in J774 macrophages

Unité de pharmacologie cellulaire et moléculaire, Université catholique de Louvain, Brussels, Belgium
* Corresponding author. Tel: +32-2-764-73-78; Fax: +32-2-764-73-73; Email: vanbambeke{at}facm.ucl.ac.be
Objectives: Quinolones accumulate in eukaryotic cells and show activity against a large array of intracellular organisms, but systematic studies aimed at examining their pharmacodynamic profile against intracellular bacteria are scarce. The present work aims at comparing intracellular-to-extracellular activities in this context.
Methods: We assessed the activities of ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin against the extracellular (broth) and intracellular (infected J774 macrophages) forms of Listeria monocytogenes (cytosolic infection) and Staphylococcus aureus (phagolysosomal infection) using a range of clinically meaningful extracellular concentrations (0.064 mg/L).
Results: All four quinolones displayed concentration-dependent bactericidal activity against extracellular and intracellular L. monocytogenes and S. aureus for extracellular concentrations in the range 14-fold their MIC. Compared at equipotent extracellular concentrations, intracellular activities against L. monocytogenes were roughly equal to those that were extracellular, but were 50100 times lower against S. aureus. Because quinolones accumulate in cells (ciprofloxacin,
3 times; levofloxacin,
5 times; garenoxacin,
10 times, moxifloxacin,
13 times), these data show that, intracellularly, quinolones are 510 times less potent against L. monocytogenes (P=0.065 [ANCOVA]), and at least 100 times less potent (P < 0.0001) against S. aureus. Because of their lower MICs and higher accumulation levels, garenoxacin and moxifloxacin were, however, more active than ciprofloxacin and levofloxacin when compared at similar extracellular concentrations.
Conclusions: Quinolone activity is reduced intracellulary. This suggests that either only a fraction of cell-associated quinolones exert an antibacterial effect, or that intracellular activity is defeated by the local environment, or that intracellular bacteria only poorly respond to the action of quinolones.
Keywords: cellular pharmacodynamics , cellular pharmacokinetics , bactericidal activity , accumulation
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