Activity In Vitro of the Quinolones

C. Thauvin-Eliopoulos; G. M. Eliopoulos

doi:10.1128/9781555817817.Ch5

Chapter 5 : Activity In Vitro of the Quinolones

Authors: C. Thauvin-Eliopoulos¹, G. M. Eliopoulos¹

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Affiliations: 1: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, and Harvard Medical School, Boston, MA 02115

Content Type: Monograph

Publication Year: 2003

Category: Clinical Microbiology

Book DOI: 10.1128/9781555817817

Chapter DOI: 10.1128/9781555817817.Ch5

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Abstract:

This chapter reviews the in vitro activities of the currently available and several investigational fluoroquinolones on the basis of data from published literature. The primary purpose of the chapter is to explore the potential antimicrobial spectrum of the class rather than to highlight specific agents. Antimicrobial activity was performed for gram-negative bacteria, gastrointestinal pathogens, respiratory tract pathogens, gram-positive bacteria, anaerobic bacteria, genital pathogens, mycoplasmas and ureaplasmas. The influence of serum on activities of fluoroquinolones in vitro is usually of minimal consequence. Minimal bactericidal concentrations (MBCs) of the various fluoroquinolone antimicrobials were almost always within two dilutions of the MIC. The newer agents seem to behave similarly. Clinafloxacin and gatifloxacin MBCs are generally within two dilutions of MICs. The bactericidal activities of fluoroquinolones have also been studied in vitro, in pharmacodynamic models that simulate serum antimicrobial concentrations following standard dosing in humans. Resistance in Staphylococcus aureus was detected after fewer passages in ciprofloxacin than in levofloxacin or trovafloxacin. In the treatment of infections due to gram-negative bacteria, it is not uncommon to witness the use of fluoroquinolones in combination with other antibiotics that display a similar antibacterial spectrum. The fluoroquinolones continue to provide excellent in vitro activity against most commonly encountered gram-negative bacteria. However, in certain areas of the world or in specific institutional settings, significant numbers of Escherichia coli or Klebsiella spp. are now resistant to available agents of this class. Rates of resistance among clinical isolates of Pseudomonas aeruginosa are higher still.

Citation: Thauvin-Eliopoulos C, Eliopoulos G. 2003. Activity In Vitro of the Quinolones, p 91-111. In Hooper D, Rubinstein E (ed), Quinolone Antimicrobial Agents, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817817.Ch5

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Tables

Activity In Vitro of the Quinolones

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/content/10.1128/9781555817817.chap5.tab5-1

Table 1

Susceptibility of Enterobacteriaceae to earlier fluoroquinolones a

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Table 1

Susceptibility of Enterobacteriaceae to earlier fluoroquinolones a

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Table 2

Susceptibility of Enterobacteriaceae to more recent quinolone antimicrobials a

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Table 2

Susceptibility of Enterobacteriaceae to more recent quinolone antimicrobials a

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Table 3

Susceptibility of nonfermenting organisms to fluoroquinolones a

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Table 3

Susceptibility of nonfermenting organisms to fluoroquinolones a

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Table 4

Activities of fluoroquinolones against miscellaneous gram-negative bacteria a

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Table 4

Activities of fluoroquinolones against miscellaneous gram-negative bacteria a

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Table 5

Susceptibilities of gastrointestinal tract pathogens to fluoroquinolone antimicrobials a

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Table 5

Susceptibilities of gastrointestinal tract pathogens to fluoroquinolone antimicrobials a

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Table 6

Susceptibility of gram-negative and atypical respiratory pathogens to quinolone antimicrobials a

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Table 6

Susceptibility of gram-negative and atypical respiratory pathogens to quinolone antimicrobials a

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Table 7

Susceptibility of gram-positive bacteria to U.S. approved fluoroquinolone antimicrobials ref-type="table-fn" rid="tfn5-7> a

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Table 7

Susceptibility of gram-positive bacteria to U.S. approved fluoroquinolone antimicrobials ref-type="table-fn" rid="tfn5-7> a

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Table 8

Susceptibility of gram-positive bacteria to investigational quinolone antimicrobials a

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Table 8

Susceptibility of gram-positive bacteria to investigational quinolone antimicrobials a

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Table 10

Expected susceptibilities of genital pathogens to fluoroquinolones a

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Table 10

Expected susceptibilities of genital pathogens to fluoroquinolones a

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Table 9

Susceptibilities of anaerobic bacteria to fluoroquinolones a

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Table 9

Susceptibilities of anaerobic bacteria to fluoroquinolones a