Quinolones (eBook)

Front Cover 1
The Quinolones 4
Copyright Page 5
Contents 6
Contributors 16
Preface 20
Chapter 1. The Quinolones: History and Overview 22
Introduction 23
Antibacterial Activity 27
Bacterial Resistance To Fluoroquinolones 29
Clinical Pharmacology 30
Clinical Uses 33
Pharmacoeconomic Aspects of Fluoroquinolone Usage 37
Use of Fluoroquinolones in Pediatrics 38
Adverse Drug Reactions 40
Interactions with Other Drugs 43
Conclusion 44
References 45
Chapter 2. Chemistry and Mechanism of Action of the Quinolone Antibacterials 54
Introduction 55
Structural and Historical Background 55
Third- and Fourth-Generation Quinolones 63
Future Directions 78
Mechanism of Action 82
Conclusion 102
References 103
Chapter 3. Comparative In-Vitro Properties of the Quinolones 120
Introduction 120
Gram-Negative Aerobes 123
Gram-Positive Aerobes 138
Anaerobes 146
Miscellaneous Organisms 151
Conclusion 153
References 153
Chapter 4. Bacterial Resistance to Quinolones:Mechanisms and Clinical Implications 160
Introduction 161
Mechanisms of Quinolone Resistance 161
Gram-Negative Bacteria 161
Gram-Positive Bacteria 167
Clinical Impact of Bacterial Resistance to Quinolones 170
References 177
Chapter 5. Pharmacokinetics and Pharmacodynamics of the Fluoroquinolones 190
Introduction 191
Basic Concepts of Pharmacokinetics and Pharmacodynamics 191
Pharmacokinetics 192
Pharmacodynamics 206
Conclusion 212
References 212
Chapter 6. Use of Quinolones in Urinary Tract Infection and Prostatitis 224
Introduction 224
Urinary Tract Infection 225
Pharmacology 228
Microbiology 228
Clinical Studies 230
Conclusion 239
References 239
Chapter 7. Use of the Quinolones in Sexually Transmitted Diseases 248
Introduction 249
Gonococcal Infections 250
Chlamydia trachomatics 256
Pelvic Inflammatory Disease 259
Chancroid 260
Donovanosis 262
Bacterial Vaginosis 262
Special Toxicity Considerations When Quinolones are Used For Treating Sexually Transmitted Diseases 263
Conclusion 264
References 264
Chapter 8. Treatment of Respiratory Infections with Quinolones 276
Introduction 276
Clinical Issues in the Therapy of Respiratory Infection 278
Pharmacological Advantages for the Use of Quinolones in Respiratory Infection 283
Microbiologic Advantages of Quinolones for Respiratory Infection 288
Clinical Efficacy of Quinolones for The Therapy of Respiratory Tract Infections 292
Conclusion 297
References 298
Chapter 9. Use of Quinolones in Surgery and Obstetrics and Gynecology 306
Introduction 306
Surgical Wound Prophylaxis 307
Soft Tissue Infection 309
Intraabdominal Infection 310
Gynecologic Infections 312
Postoperative Pelvic Infections 314
Pelvic Inflammatory Disease 315
Upper Genital Tract Infection 316
Pregnancy 317
Conclusion 318
References 318
Chapter 10. Use of the Quinolones for Treatment and Prophylaxis of Bacterial Gastrointestinal Infections 324
Introduction 325
Clinical Studies 326
Antimicrobial Resistance to Quinolones 337
Conclusion 338
References 339
Chapter 11. Use of the Quinolones in Treatment of Bacterial Meningitis 346
Introduction 346
Pharmacology 347
Microbiology 356
Studies of Clinical Efficacy 357
Conclusion 360
References 360
Chapter 12. Use of the Quinolones in Immunocompromised Patients 364
Introduction 364
Risk Factors and Associated Infections 365
Rationale for Fluoroquinolone Use 367
Effect of Fluoroquinolones on Endogenous Microflora 368
Infection Prevention in Afebrile Neutropenic Patients 369
Empiric Therapy in Febrile Neutropenic Patients 371
Risk-Based Therapy for Febrile Neutropenia 373
Treatment Of Specific Infections 375
Conclusion 380
References 381
Chapter 13. Use of the Quinolones in Skin and Skin structure (Osteomyelitis) and Other Infections 392
Introduction 392
Skin and Soft Tissue Infection 393
Bone and Joint Infection 399
Conclusion 410
References 411
Chapter 14. Safety Overview: Toxicity, Adverse Effects,and Drug Interactions 418
Introduction 419
Toxicity Of Quinolones (Studies in Animals) 420
Adverse Effects of Fluoroquinolones in Clinical Studies 434
Drug Interactions 454
References 463
Chapter 15. Use of the Quinolones in Pediatrics 476
Introduction 476
Animal Data 477
Pharmacokinetics 481
Clinical Experiences 481
Newest Compounds 488
Recommendations 489
Conclusion 489
References 490
Chapter 16. The Quinolones: Prospects 498
Introduction 498
Molecular Mechanisms of The Quinolones: Key Discoveries 499
Microbiology 501
Pharmacokinetics 502
Clinical Uses 503
Adverse Events 504
Quinolones: Future Developments 507
Current Quinolone Status and Classification 508
Conclusion 511
References 512
Index 518