The potency/efficacy of the fluoroquinolones in community-acquired pneumonia

This article reviews the efficacy of fluoroquinolones for treating community-acquired pneumonia (CAP) and discuss clinical advantages of fluoroquinolones relative to other drug classes. Of 19 randomized, controlled trials comparing a fluoroquinolone with another agent or combination of agents in CAP, 6 trials have demonstrated superiority of the fluoroquinolone with respect to clinical and/or bacteriologic efficacy. Few head-to-head comparisons have evaluated the relative efficacy of different fluoroquinolones. Advantageous characteristics of the newer fluoroquinolones include once-daily dosing and excellent penetration into pulmonary compartments. Furthermore, the availability of intravenous formulations of ciprofloxacin (Cipro(R)), moxifoxacin (Avelox(R)), levofloxacin (Levaquin(R)), and gatifloxacin (Tequin(R)) may facilitate the treatment of patients with CAP. The anti-inflamatory activity of certain fluoroquinolones may contribute to their efficacy by reducing the clinical symptoms associated with the immune response. With appropriate restrictions to limit the emergence of resistance, the third- and fourth-generation fluoroquinolones will continue to be instrumental in managing CAP.