New fluoroquinolones: levofloxacin, moxifloxacin and gatifloxacin
Abstract
Since their introduction in the seventies, the fluoroquinolones have gained an important place in the treatment of Gram-negative infections. Modifications in their structure have led to a number of newer agents with improved activity against Gram-positive microorganisms. Among these new agents are gatifloxacin, levofloxacin and moxifloxacin, which have been registered in The Netherlands. These new fluoroquinolones are promoted by the manufacturers for use in respiratory tract infections, notably in community-acquired pneumonia. Studies have shown that these agents may be somewhat more effective than the current antibiotics in use in The Netherlands for community-acquired pneumonia. Given the fact that penicillin resistance among pneumococci hardly occurs in The Netherlands and the severe risk of the development of resistance in both Gram-positive and Gram-negative microorganisms when the new fluoroquinolones are used, their area of indication would currently seem to be limited.
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