Oral fluoroquinolone versus mono- or combination parenteral therapy in the management of bacterial infections: a critical appraisal.

There has been a great deal of interest in the use of oral fluoroquinolone monotherapy rather than mono- or combination parenteral therapy in the management of serious bacterial infections. A review of the published comparative studies and abstracts indicates that, overall, oral fluoroquinolones were at least as effective as, and certainly less expensive than, the parenteral agents studied. However, the spectrum of infection types and the number of patients studied in comparative trials have been small. In addition, ofloxacin and enoxacin were underrepresented in the study material. Oral fluoroquinolones were devoid of the serious adverse effects associated with the aminoglycosides, vancomycin, and the methylthiotetrazole-containing cephalosporins. In general, the incidence of minor adverse effects were similar for the oral fluoroquinolones and comparison parenteral regimens. Meta-analysis of the published reports and abstracts revealed that the oral fluoroquinolones are as effective as parenteral mono- or combination regimens for the treatment of serious bacterial infections in selected patient populations.