Fourth generation fluoroquinolones: New weapons in the arsenal of ophthalmic antibiotics
Fourth generation fluoroquinolones: New weapons in the arsenal of ophthalmic antibiotics
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DOI：
10.1016/s0002-9394(02)01334-x
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发表时间：
2002-04-01
影响因子：
4.2
通讯作者：
Kowalski, RP
中科院分区：
文献类型：
--
作者：
Mather, R;Karenchak, LM;Kowalski, RP
目的：第四代氟喹诺酮类药物（FQs）即将被引入眼科。本体外实验比较了第四代FQs（加替沙星- gat和莫西沙星- mox）与第三代FQs（左氧氟沙星- lev）和第二代FQs（环丙沙星- cip和氧氟沙星- ofx）在药敏模式和药效方面的差异。设计：实验实验室调查。方法：回顾性分析93株细菌性眼内炎分离菌对CIP、OFX、LEV、GAT和MOX的最低抑菌浓度（mic）。国家临床实验室标准委员会（NCCLS）的药敏模式和mic的效力进行统计比较。结果：体外实验显示，对CIP和OFX耐药的金黄色葡萄球菌对MOX最敏感（P = 0.01）。对CIP和OFX耐药的凝固酶阴性葡萄球菌对MOX和GAT最敏感（P = 0.02）。青绿链球菌对MOX、GAT和LEV的易感程度高于CIP和OFX （P = 0.02）。肺炎链球菌对OFX的敏感性最低（P = 0.01）。所有其他细菌组的敏感性相等（P = .11）。总的来说，MOX是革兰氏阳性菌最有效的FQ (P = 0.05)，而CIP、MOX、GAT和LEV对革兰氏阴性菌的效力相当。结论：本体外研究表明，第四代FQs似乎覆盖了细菌对第二代和第三代FQs的抗性，对革兰氏阳性菌的抗性比第二代和第三代FQs强，对革兰氏阴性菌的抗性同样强。临床研究将需要证实这些结果。(C) 2002年由爱思唯尔科学公司版权所有。
PURPOSE: Fourth generation fluoroquinolones (FQs) will soon be introduced to ophthalmology. In this in vitro study, differences in the susceptibility patterns and the potencies of fourth generation FQs (gatifloxacin-GAT and moxifloxacin-MOX) were compared with third generation (levofloxacin-LEV) and second generation FQs (ciprofloxacin-CIP and ofloxacin-OFX).DESIGN: Experimental laboratory investigation.METHODS: In retrospect, the minimum inhibitory con. centrations (MICs) of 93 bacterial endophthalmitis isolates were determined to CIP, OFX, LEV, GAT, and MOX using E-tests. The National Committee of Clinical Laboratory Standards (NCCLS) susceptibility patterns and the potencies of the MICs were statistically compared.RESULTS: With in vitro tests, Staphylococcus aureus isolates that were resistant to CIP and OFX were statistically most susceptible (P = .01) to MOX. Coagulase negative Staphylococci that were resistant to CIP and OFX were statistically most susceptible (P = .02) to MOX and GAT. Streptococcus viridans were more susceptible (P = .02) to MOX, GAT, and LEV than CIP and OFX. Streptococcus pneumoniae was least susceptible (P = .01) to OFX compared with the other FQs. Susceptibilities were equivalent (P = .11) for all other bacterial groups. In general, MOX was the most potent FQ for gram-positive bacteria (P = .05) while CIP, MOX, GAT, and LEV demonstrated equivalent potencies to gram-negative bacteria.CONCLUSIONS: This in vitro study indicated that fourth generation FQs appear to cover bacterial resistance to the second and third generation FQs, were more potent than the second and third generation FQs for gram-positive bacteria, and are equally potent for grams negative bacteria. Clinical studies will need to confirm these results. (C) 2002 by Elsevier Science Inc. All rights reserved.