The evolving role of quinolones in respiratory tract infections

Treatment of respiratory tract infections is leading use of prescription antibiotics in both the hospital and community settings. Fluoroquinolones are not widely used in the management of upper respiratory tract infections, which, apart from sinusitis, are largely pediatric infections, for which fluoroquinolones are contraindicated. In contrast, fluoroquinolones are being used increasingly to treat lower respiratory infections (LRTIs). Their advantages include broad-spectrum, rapid bactericidal activity and good tissue penetration, including penetration into intracellular sites. Several new fluoroquinolones, including grepafloxacin, exhibit enhanced activity against Streptococcus pneumoniae, including penicillin-resistant strains. This, together with activity against atypical pathogens, makes them potentially attractive for the treatment of the range of LRTI syndromes in adults.