What are the indications for fluoroquinolones in respiratory infections?

From the Guidelines

Fluoroquinolones are indicated for the treatment of respiratory infections, including community-acquired pneumonia (CAP), in adults with underlying comorbidities or those who have been exposed to antibiotic agents within the previous 3 months.

Indications for Fluoroquinolones

• Community-acquired pneumonia (CAP): Fluoroquinolones, such as levofloxacin, moxifloxacin, and gemifloxacin, are recommended for the treatment of CAP in adults with underlying comorbidities or those who have been exposed to antibiotic agents within the previous 3 months 1.
• Acute exacerbation of chronic bronchitis: Fluoroquinolones, such as levofloxacin and moxifloxacin, are effective in treating acute exacerbation of chronic bronchitis 1.
• Acute bacterial rhinosinusitis: Fluoroquinolones, such as levofloxacin and moxifloxacin, are effective in treating acute bacterial rhinosinusitis, especially in patients with underlying comorbidities or those who have been exposed to antibiotic agents within the previous 3 months 1.

Important Considerations

• Resistance: The increasing resistance of pneumococci to fluoroquinolones is a concern, and the use of these agents should be guided by local resistance patterns 1.
• Dosage: The dosage of fluoroquinolones, such as levofloxacin, may need to be adjusted to overcome resistance, with a higher dose of 750 mg daily recommended for adults with pneumonia 1.
• Safety: Fluoroquinolones, such as ciprofloxacin, have been associated with adverse effects, including tendon rupture and photosensitivity, and should be used with caution in patients with underlying medical conditions 1.

From the Research

Indications for Fluoroquinolones in Respiratory Infections

The fluoroquinolones are a class of antibiotics that have been shown to be effective in the treatment of various respiratory infections, including:

• Community-acquired pneumonia (CAP) 2, 3, 4, 5, 6
• Acute exacerbations of chronic bronchitis (AECB) 3, 5, 6
• Acute sinusitis 5
• Lower respiratory tract infections (LRTIs) 3, 4, 6

Specific Indications

The following fluoroquinolones have been shown to be effective in the treatment of respiratory infections:

• Levofloxacin 2, 3, 4, 5
• Moxifloxacin 2, 3, 4, 5
• Gatifloxacin 2, 3, 4, 5
• Gemifloxacin 3, 4, 5

Considerations for Use

When using fluoroquinolones to treat respiratory infections, the following considerations should be taken into account:

• Resistance patterns of the causative organisms 3, 4, 5
• Pharmacokinetic and pharmacodynamic properties of the fluoroquinolone 3, 4, 5
• Potential for adverse effects and drug interactions 5, 6
• Cost-effectiveness of the fluoroquinolone 6