PubMed · 2000 · 298 citations · 6 references
Antibacterial AgentsQuinolone DrugsFourth-generation Quinolone DrugsAntimicrobial ChemotherapyDrug ResistanceMedicinal ChemistryAntimicrobial StewardshipAntimicrobial ResistanceHealth SciencesQuinolone AntibioticsNewer FluoroquinolonesAntimicrobial PharmacokineticsAntimicrobial CompoundPharmacologyClinical MicrobiologyAntimicrobial SusceptibilityAntibioticsAntimicrobial PharmacodynamicsMedicineDrug Discovery
Fluoroquinolones are broad‑spectrum bactericidal agents with excellent oral bioavailability, good tissue penetration, and favorable safety, and they are categorized into generations that differ in serum levels and antimicrobial spectrum against gram‑negative, gram‑positive, atypical pathogens, and anaerobes. The study proposes a new four‑generation classification of quinolone drugs that reflects their expanded antimicrobial spectrum and clinical indications. The classification groups drugs by generation, considering their pharmacokinetic properties and spectrum of activity. The new classification can help family physicians prescribe these drugs appropriately.
The newer fluoroquinolones have broad-spectrum bactericidal activity, excellent oral bioavailability, good tissue penetration and favorable safety and tolerability profiles. A new four-generation classification of the quinolone drugs takes into account the expanded antimicrobial spectrum of the more recently introduced fluoroquinolones and their clinical indications. First-generation drugs (e.g., nalidixic acid) achieve minimal serum levels. Second-generation quinolones (e.g., ciprofloxacin) have increased gram-negative and systemic activity. Third-generation drugs (e.g., levofloxacin) have expanded activity against gram-positive bacteria and atypical pathogens. Fourth-generation quinolone drugs (currently only trovafloxacin) add significant activity against anaerobes. The quinolones can be differentiated within classes based on their pharmacokinetic properties. The new classification can help family physicians prescribe these drugs appropriately.
6