Pharmacokinetics and efficacy of the new quinolones in infections of the eye, ear, nose, and throat.

A review of published data indicates that the new quinolones readily penetrate the tissues and secretions of the upper respiratory tract. The concentrations of ciprofloxacin and ofloxacin in tonsillar tissue and the concentrations of ofloxacin in the mucosa of the paranasal sinuses generally exceeded the peak concentrations of these agents in serum after oral administration of the drugs. Good penetration was noted for ciprofloxacin into nasal secretions, ofloxacin into tears, and various quinolones into saliva. Penetration into ocular humors appears to be moderate. Reports in English concerning clinical trials of the new fluoroquinolones in the treatment of infections of the eyes, ears, nose, and throat are sparse, but a number of studies of ofloxacin have been published in Japanese. The data suggest that the new quinolones may be useful for the treatment of acute sinusitis and chronic suppurative otitis media. However, studies comparing these agents with more established drugs and using carefully defined criteria for diagnosis and for evaluation of the response to treatment are needed.