Role of the newer fluoroquinolones against penicillin-resistant Streptococcus pneumoniae

STREPTOCOCCUS pneumoniae has long been associated with a number of communit y-acquired infections. Although the incidence of S. pneumoniae's associatio n with various infections (e.g., pneumonia, sinusitis, otitis media) varies from study to study, S. pneumoniae is by far the most frequently encounter ed pathogen in community-acquired respiratory tract infections. Millions of dollars each year are spent worldwide on antimicrobials to combat pneumoco ccal infections. As recently as 15 years ago, penicillin was still consider ed the antimicrobial of choice for the treatment of S. pneumoniae. Although penicillin resistance among pneumococci had been reported decades earlier, it was not until the early 1990s that the true magnitude and impact of pne umococcal resistance was appreciated. The recognition of drug-resistant S. pneumoniae as a formidable clinical concern has prompted prescribers to ree valuate the therapeutic strategies used against pneumococci and to search f or treatment options with reliable activity against this emerging multidrug -resistant pathogen. This review addresses the evolving resistance of S. pneumoniae to agents tr aditionally used to treat pneumococcal infections (e.g., the beta-lactams a nd macrolides). Additionally, the in vitro activity and potential role of n ewer broader-spectrum fluoroquinolones against S. pneumoniae are evaluated.