Therapeutic focus. The fluoroquinolones.

The family of fluoroquinolones is an attractive group of bactericidal antibiotics with a wide range of activity against Gram-negative organisms and some Gram-positive bacteria. In addition to being highly bactericidal, these antibiotics are effective by mouth, side effects are few and bacterial resistance is minimal. These antibiotics have an assured place in the management of urinary tract infections, gonorrhoea, chlamydial infection, cystic fibrosis, typhoid fever, travellers' diarrhoea, biliary infection and as an alternative agent in respiratory infections. Nalidixic acid was the pioneer quinolone, but has now been succeeded by a whole new family of fluoroquinolones with greater bactericidal activity and a considerably wider antibacterial spectrum. Ciprofloxacin (Ciproxin, Bayer UK Ltd) is joined by norfloxacin (Noroxin, Merck, Sharpe & Dohme), perfloxacin, ofloxacin and enoxacin. This family of fluoroquinolones is attractive because effective treatment can be given by mouth, they are highly bactericidal, side effects are minimal and the spectrum of bacterial resistance seems to be small. There is also an obvious economic advantage over parenterally-administered drugs.