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Expanding Uses of Fluoroquinolones: Opportunities and Challenges

David C. Hooper, MD
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Massachusetts General Hospital; Boston, MA 02114-2696 Note: Dr. Hooper has received investigator-initiated grant support from several manufacturers of quinolone antibiotics and has served on advisory boards for other companies that make these products. Requests for Reprints: David C. Hooper, MD, Infectious Disease Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114-2696; e-mail, dhooper@partners.org.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(11_Part_1):908-910. doi:10.7326/0003-4819-129-11_Part_1-199812010-00015
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Drugs in the quinolone or related naphthyridine class have been available since the 1960s. Nalidixic acid, the first agent of the class to be used clinically, was largely limited to treatment of urinary tract infections. The mid-1980s saw the introduction of newer, more potent, fluorinated quinolones with broader spectra of activity and broader applications for treatment of bone, joint, and systemic infections and infections of the genital, gastrointestinal, and respiratory tracts [1]. Of the five fluoroquinolones introduced in the United States by 1992, ciprofloxacin and ofloxacin were most widely used because they had the greatest potency and the broadest set of approved indications [2]. Both of these agents were available in oral and intravenous formulations given twice daily and were generally well tolerated. Ciprofloxacin and ofloxacin were most active against gram-negative bacilli, less active against gram-positive cocci, and insufficiently active against anaerobic bacteria.

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