oa Southern African Journal of Epidemiology and Infection - Fluoroquinolone treatment of pneumococcal infections : editorial
Fluoroquinolones are widely advocated as first line agents for the management of pneumonia, particularly in the USA, for outpatient therapy of patients who have recently been exposed to antibiotics, or who have comorbidities that increase their risk of serious infection. Empiric therapy guidelines for community-acquired pneumonia in hospitalised pneumonia also include so-called respiratory fluoroquinolones as first line agents. The broad spectrum of their activity against both typical and atypical respiratory pathogens make these agents attractive, especially as they are well absorbed orally and generally well tolerated. The initially licensed fluoroquinolones, ciprofloxacin and ofloxacin, had limited activity against the pneumococcus, and a variety of new agents have come to the market to fill this gap. The L-isomer of ofloxacin was shown to harbour better activity than the D-isomer of that drug and the L-isomer formulation was licensed as levofloxacin and has come to dominate this market. In the current issue Moolman and colleagues compare the activity of levofloxacin to two other more active agents available in South Africa, and conclude both on the basis of in vitro activity, and the achievable drug concentrations that gatifloxacin and moxifloxacin offer greater potential killing of this pathogen.
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