Quinolones in Community-Acquired Pneumonia; Are They Born Equal?
Keywords:
CAP, Quinolones, PK/PD, quinolones resistance, fluoroquinolones.Abstract
There has been debate on the best treatment regimen for CAP, whether to start treatment with β-lactams, β-lactam β-lactamase inhibitor, macrolides, a combination of the earlier or quinolones, among other less commonly used agents. In this review, an attempt to examine some data on the utilization and importance of respiratory quinolones in the treatment of CAP, and to examine whether quinolones are the same in clinical and microbiological efficacy, shall we stick to seven days of treatment versus shorter duration without compromising outcome? Are resistance patterns for respiratory quinolones the same, and are there savings associated with using some respiratory quinolones over others? Moreover, are there any differences in mortality when examined as a treatment end-point, and if there is any differences in speed of recovery for different respiratory quinolones? Do we need to incorporate pharmacokinetics/pharmacodynamics principles in the treatment CAP, and how to dose anti-infective agents in CAP, opposed to leaving treatment-doses for minimum inhibitory concentration alone?
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