Trovafloxacin: A new fluoroquinolone

OBJECTIVE: TO review the pharmacology, antimicrobial activity, pharmacokine tics, clinical efficacy, and safety of trovafloxacin. DATA SOURCES: A MEDLINE search (January 1966-April 1998) was conducted for relevant literature using the terms CP-99, 219, CP-116,519, trovafloxacin, and alatrofloxacin. Abstracts published by the American Society of Microbio logy during 1995-1997 meetings were also reviewed. STUDY SELECTION AND DATA EXTRACTION: All in vitro, animal, and human studie s were reviewed for the antimicrobial activity, pharmacokinetics, efficacy, and safety of trovafloxacin. DATA SYNTHESIS: Trovafloxacin is a new fluoroquinolone with enhanced activi ty against gram-positive and anaerobic microorganisms. The oral bioavailabi lity under fasting conditions is approximately 88%. The elimination half-li fe of trovafloxacin is approximately 10 hours. Less than 10% of trovafloxac in is eliminated unchanged in the urine. Trovafloxacin is effective in the treatment of community-acquired pneumonia and nosocomial pneumonia with cur e rates of >90% and 77%, respectively. Trovafloxacin is comparable with cef triaxone in the treatment of meningococcal meningitis in children; each pro duces a cure rate of similar to 90%. In treatment of uncomplicated urinary tract infection, both ciprofloxacin and trovafloxacin achieve an eradicatio n rate of greater than or equal to 93%. Trovafloxacin is similar to ofloxac in in the treatment of urogenital Chlamydia trachomatis and acute exacerbat ions of chronic bronchitis, with clinical success in 97% of patients with e ach drug. The common adverse effects of trovafloxacin include dizziness, he adache, and gastrointestinal intolerance. CONCLUSIONS: The advantages of once-daily dosing and enhanced activity of t rovafloxacin against grant-positive and anaerobic organisms may expand its use over available fluoroquinolones, Further studies are needed to define i ts role in the treatment of various infectious diseases.