SPARFLOXACIN - A REVIEW OF ITS ANTIBACTERIAL ACTIVITY, PHARMACOKINETIC PROPERTIES, CLINICAL EFFICACY AND TOLERABILITY IN LOWER RESPIRATORY-TRACT INFECTIONS

Sparfloxacin is a fluoroquinolone antibacterial agent with activity ag ainst a broad range of Gram-negative and Gram-positive organisms inclu ding Streptococcus pneumoniae, one of the main pathogens in community- acquired pneumonia. In this infection, sparfloxacin has shown efficacy similar to that of amoxicillin, erythromycin, roxithromycin, amoxicil lin/clavulanic acid and amoxicillin plus ofloxacin, producing clinical cure rates of 80 to 84% assessed by intention-to-treat analyses in Eu ropean or multinational trials. US studies showed similar results for sparfloxacin to those for erythromycin and cefaclor: Sparfloxacin was also as effective as all other comparator drugs in patients with other lower respiratory tract infections, usually acute exacerbations of ch ronic obstructive pulmonary disease (COPD). The profile of adverse eff ects for sparfloxacin is generally similar to that of other quinolones : gastrointestinal discomfort and CNS effects are the most common in c linical trials. Sparfloxacin causes fewer gastrointestinal disturbance s than agents such as amoxicillin and erythromycin and does not intera ct with theophylline, an important consideration when treating patient s with respiratory disease. its long elimination half-life permits onc e-daily dosage regimens. On the other hand, there are infrequent repor ts of prolonged QT(c) interval (3% increase) during sparfloxacin thera py. Photosensitivity occurs more frequently than with the other fluoro quinolones (2% of patients in an ongoing postmarketing study and 7.9% of those in US trials), and requires ongoing surveillance. In summary, the good activity of sparfloxacin against S. pneumoniae and other res piratory pathogens supports its use in lower respiratory tract infecti ons, particularly community-acquired pneumonia. Its profile of good ef ficacy, once-daily dosage, good gastrointestinal tolerability and lack of inter-action with theophylline are advantageous, but clinicians an d patients must be alert to the possibility of photosensitivity reacti ons. On this basis, sparfloxacin, when appropriately prescribed, can p rovide the clinician with a useful alternative treatment option for th ese common infections.