K. Waites et al., MULTICENTER IN-VITRO COMPARATIVE-STUDY OF FLUOROQUINOLONES AFTER 4 YEARS OF WIDESPREAD CLINICAL USE, Diagnostic microbiology and infectious disease, 18(3), 1994, pp. 181-189
In vitro activities of ciprofloxacin, fleroxacin, lomefloxacin, ofloxa
cin, and seven other oral antimicrobials including amoxicillin-clavula
nic acid (A/C), oxacillin, cefaclor, cefixime, cefuroxime, erythromyci
n, and trimethoprim-sulfamethoxazole (T/S) were evaluated against 1708
fresh bacterial isolates from four hospital laboratories similar to 4
years otter the introduction of ciprofloxacin. T/S and ofloxacin had
the lowest MIC(90)s and greatest percentage of susceptible strains ove
rall, followed by the other three quinolones. Quinolones were the most
active drugs tested against Gram-negative bacteria, with little varia
tion in the activity among the four compounds against most species. Q
uinolone resistance was detected to some degree in the majority of Gra
m-negative species tested, with Pseudomonas, Acinetobacter, Xanthomona
s, and Providencia demonstrating the highest percentage of resistant s
trains. Ofloxacin and ciprofloxacin were relatively more active agains
t Gram-positive bacteria than were fleroxacin and lomefloxacin, but T/
S and A/C had more susceptible strains than any of the quinolones. Oxa
cillin-resistant staphylococci, enterococci, land streptococci exhibit
ed the least quinolone susceptibility. This study showed that while re
sistance is developing among several previously susceptible bacterial
species, quinolones remain important alternatives for the oral treatme
nt of many types of infections. Actions to prevent or limit resistance
will be important to maintain the viability of the quinolones as ther
apeutic agents in both hospital and community environments.