fluorokinololon

Fluorokinololon, commonly referred to as fluoroquinolones, is a class of synthetic broad-spectrum antibiotics. They inhibit bacterial DNA gyrase (topoisomerase II) and often topoisomerase IV, enzymes required for DNA replication and transcription, producing bactericidal effects. The drugs typically have good activity against many Gram-negative bacteria and several Gram-positive cocci, with variable activity against anaerobes. Representative agents include ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin, and newer agents such as delafloxacin.

Pharmacokinetics vary by compound but many are orally bioavailable with good tissue penetration. Elimination is primarily renal for some agents and hepatic for others; absorption can be reduced by multivalent cations (calcium, magnesium, aluminum), iron, and certain antacids. Adverse effects include tendinopathy and tendon rupture, peripheral neuropathy, CNS effects, QT interval prolongation, and disturbances of glucose homeostasis. Because of safety concerns, they are generally avoided in children and during pregnancy, and are reserved for specific indications in adults.

Uses and resistance: fluoroquinolones are employed for various infections such as complicated urinary tract infections, some intra-abdominal and gynecologic infections, community-acquired pneumonia, and certain skin infections, depending on local guidelines and resistance patterns. Resistance often arises from mutations in gyrA/gyrB and parC/parE, plus efflux or plasmid-mediated resistance, reducing efficacy. Regulatory agencies emphasize cautious use to minimize adverse outcomes and resistance.