In vitro activity of four fluoroquinolones against clinical isolates of Pseudomonas aeruginosa determined by the E test.

Ciprofloxacin, levofloxacin, ofloxacin, and trovafloxacin were tested by the E-test against 100 clinical isolates of Pseudomonas aeruginosa. Ciprofloxacin was the most active of the tested agents with 82% of isolates having a MIC </=1 mg/l (range: 0.094->8). Levofloxacin and trovafloxacin had nearly identical potency: 75% and 76% of the isolates were inhibited by </=2 mg/l of these agents, respectively (range: 0.125->8 for levofloxacin; 0.19->8 for trovafloxacin). Ofloxacin was the least active of the four quinolones, with 43% of the isolates having a MIC >2 mg/l. All isolates resistant to ciprofloxacin were also resistant to the other agents, i.e. resistance to ciprofloxacin predicted resistance to all the quinolones tested in every case. This data demonstrates that fluoroquinolones are active agents against P. aeruginosa. In vitro susceptibility testing, however, is crucial to assess the resistance pattern in any specific location and for each individual agent.