The evolution of fluorinated quinolones: pharmacology, microbiological activity, clinical uses, and toxicities.

The fluorinated quinolones expand the spectrum of antimicrobial activity of the first-generation agents and offer more favorable pharmacokinetic and safety profiles than the older agents. Additionally, the need for only one daily administration of the third-generation quinolones may improve patient compliance. Data from clinical trials suggest that the oral fluoroquinolones provide cost-effective, outpatient therapy for infections previously treated in hospitals with parenteral antimicrobial agents (16). The third-generation agents do not interfere with metabolism of theophylline, thus making fluoroquinolone treatment of patients receiving theophylline potentially more safe. Given the current focus on cost-containment strategies in health care, the fluorinated quinolones have become an attractive choice for therapy against a variety of bacterial infections. The future for antimicrobials and specifically quinolones looks especially bright with third-generation agents like lomefloxacin under development.