Fluorooquinolone

Fluoroquinolones are a class of antimicrobial medications that inhibit bacterial DNA gyrase and topoisomerase IV enzymes, crucial for bacterial DNA replication and transcription. These antibiotics were first introduced in the 1980s and have since become a mainstay of treatment for various bacterial infections, including respiratory tract infections, urinary tract infections, and skin and soft tissue infections.

Fluoroquinolones exert their antimicrobial activity by binding to their target enzymes, thereby preventing DNA replication and transcription. This mechanism of action allows for a broad spectrum of activity against both Gram-positive and Gram-negative bacteria. The fluoroquinolone core structure consists of a quinolone nucleus, a substituted piperazine ring, and a substituted aromatic ring.

While fluoroquinolones are effective against a wide range of bacterial pathogens, their use has been associated with adverse effects, particularly affecting the musculoskeletal system. Tendinitis and tendon rupture cases have been reported, particularly in patients aged 60 and above. Additionally, fluoroquinolones have been linked to peripheral neuropathy, central nervous system effects, and gastrointestinal disorders.

Resistance to fluoroquinolones has emerged as a concern, particularly among Gram-negative bacteria like Escherichia coli and Pseudomonas aeruginosa. Clostridioides difficile-related diarrhea has also been reported in patients treated with these antibiotics. As a result, fluoroquinolone use should be judicious and based on local resistance patterns and antimicrobial stewardship practices.

Fluoroquinolones are available in various formulations, including oral tablets, injectable solutions, and inhalers. Newer fluoroquinolones, such as moxifloxacin and gatifloxacin, have been developed to offer improved efficacy and safety profiles. However, their expanded indications and tolerability should be weighed against the risk of adverse effects and resistance development.