The first quinolone compound, nalidixic acid, showed activity against a limited number of Gram-negative micro-organisms. ‘One step’ resistance developed hiin vitro and during treatment. Resistance was not mediated by transfer of R-plasmids, which is a characteristic of all quinolones. Newer quinolones like oxolinic acid, piromidic acid, cinoxacin and pipemidic acid exhibit an extended spectrum of activity against Gram-negative bacteria at lower MIC values. In recent years fluorinated quinolones were introduced like ciprofloxacin, norfloxacin, pefloxacin, ofloxacin, enoxacin and amifloxacin. These compounds exhibitin vitro a broad spectrum of activity against Gram-negative and Gram-positive bacteria at MIC values seventy to four hundred times less than those for nalidixic acid. Thein vitro activity of these compounds has been investigated in a large study of uncomplicated urinary tract infections in general practice (PINISU). No resistance was found. The fluorinated quinolones are very promising antimicrobial agents for a limited number of indications.
Key wordsDrug resistance In vitro activity Quinolones Spectrum of activity
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- 1.Hovelius B, Mardh P, Bygren P. Urinary tract infections caused byStaphylococcus saprophyticus: recurrences and complications. J Urol 1979;122:645–7.Google Scholar
- 2.Latham RH, Running GK, Stamm WE. Urinary tract infection in young adult women caused byStaphylococcus saprophyticus. JAMA 1983;250:3063–6.Google Scholar
- 3.Maskell R. Importance of coagulase-negativeStaphylococci as pathogens in the urinary tract. Lancet 1974;1:1155–8.Google Scholar
- 4.Ericsson HM, Sherris JC. Antibiotic sensitivity testing. Report of an International Collaborative Study (ICS). Acta Pathol Microbiol Scand 1971;section B(suppl 217).Google Scholar
- 5.Greenwood D, Osman M, Goodwin J, Cowlishaw WA, Slack R. Norfloxacin: activity against urinary pathogens and factors influencing the emerge of resistance. J Antimicrob Chemother 1984;13:315–23.Google Scholar
- 6.King A, Shannon K, Philips I. Thein vitro activity of ciprofloxacin compared with that of norfloxacin and nalidixic acid. J Antimicrob Chemother 1984;13:325–31.Google Scholar
- 7.Moreau N, Badet B, Cerceau C, Le Goffic F.In vitro studies of pefloxacin, a new quinolone related to nalidixic acid. Chemioterapia 1982;1:445–50.Google Scholar
- 8.Reeves DS, Bywater MJ, Holt HA, White LO.In vitro studies with ciprofloxacin, a new 4-quinolone compound. J Antimicrob Chemother 1984;131:333–46.Google Scholar
- 9.Thabaut A, Durasoir JL. Comparativein vitro antibacterial activity of pefloxacin (1589 RB), nalidixic acid, pipemidic acid and flumequin. Drugs Exp Clin Res 1983;9:229–34.Google Scholar
- 10.Barry AL, Jones RN. Cross-resistance among cinoxacin, ciprofloxacin, DJ-6783, enoxacin, nalidixic acid. norfloxacin and oxolinic acid afterin vitro selection of resistant populations. Antimicrob Agents Chemother 1984;23:559–64.Google Scholar