NEW FLUOROQUINOLONES - TOWARDS EXPANDED INDICATIONS

New fluoroquinolones, such as clinafloxacin, grepafloxacin, levofloxac in, sparfloxacin, tosufloxacin and trovafloxacin, are characterized by markedly improved activity against Gram-positive bacteria, e.g. pneum ococci and enterococci, and also better activity against atypical orga nisms such as mycoplasmas and chlamydiae. Use in experimental infectio ns and clinical trials confirms that these new antibiotics can be used in the treatment of lower respiratory tract infections. Such infectio ns are extremely common, however, and therefore the routine empirical use of fluoroquinolones, especially in community-acquired respiratory tract infections such as acute bronchitis and sinusitis and in acute e xacerbations of chronic bronchitis, would probably result in rapidly i ncreasing resistance problems. Therefore one should consider limiting the expansion of fluoroquinolone use to respiratory tract infections w here empiric treatment is necessary and standard treatment is likely t o fail, e.g. as a result of resistance.