Active Ingredients: Ciprofloxacin
Acinetobacter spp. However, strains which produce metallo-beta-lactamases MBL are susceptible to aztreonam.
Because of the structural differences, cross-allergies with beta-lactam antibiotics are unlikely.
The clinical relevance of aztreonam is limited. It can be used in combination with antibiotics effective against gram-positive bacteria.
Fluoroquinolones As recommended by the PEG, fluoroquinolones are categorized into 4 groups.
Since only groups 2 through 4 include parenterally available drugs, only these three groups will be considered here. Fluoroquinolones show concentration-dependent bactericidal activity with a generally broad spectrum of activity.The quinolone antibiotic ciprofloxacin was recently shown to inhibit growth and to.
The differences between the groups are discussed in the following section. The growing resistance rates in Escherichia coli and other enterobacteriaceae clearly limit the use of fluoroquinolones for empiric initial monotherapy, particularly in nosocomial infections.
Cross-resistance among all fluoroquinolones is the rule. Levofloxacin is eliminated almost exclusively via the kidneys while ciprofloxacin shows some biliary and transintestinal elimination as well.
Moxifloxacin is metabolized extensively via conjugation. The half-life is 3—4 hours for ciprofloxacin, 7—8 hours for levofloxacin, and more than 10 hours for moxifloxacin, which explains the different dosing intervals.
Group 2 fluoroquinolones: ciprofloxacin, ofloxacin Ciprofloxacin has excellent activity against gram-negative enterobacteria and H. It is only weakly active against staphylococci and clinically inadequate against pneumococci and enterococci.
Moreover, ciprofloxacin is less active against Chlamydia, Legionella and Mycoplasma spp. Licensed indications include uncomplicated and complicated renal and urinary tract infections, ENT infections, respiratory tract infections excluding pneumococcal infections, abdominal infections, genital organ infections, bones and joint infections, skin and soft tissue infections, bacterial sepsis, and infections in neutropenic patients.
The use of ofloxacin is no longer recommended see below. Group 3 fluoroquinones: levofloxacin Levofloxacin is the L enantiomer and therefore the active entity of the racemic substance ofloxacin: its antibacterial activity is twice as high.
Compared with ciprofloxacin, it shows improved efficacy against gram-positive pathogens such as staphylococci, streptococci and pneumococci as well as against Legionella, Chlamydia and Mycoplasma spp. Against gram-negative pathogens it is similarly active as ciprofloxacin, although it is somewhat less effective against P.
Levofloxacin is licensed for the treatment of community-acquired pneumonia, complicated urinary tract infections, and skin and soft tissue infections.