Antimicrobials fluoroquinolones

Flumequine is a representative of fluoroquinolones which are high-effective antimicrobial medicines used as fodder supplements in cattle-breeding. This causes the necessity in effective testing techniques to detenuine the content of flumequine in meat products. Fluorimetric determination based on sensitized luminescence of fluoroquinolone chelates with lanthanides is a promising one. The literature lacks information of flumequine detemiination with the aid of sensitized fluorescence. 

Antimicrobial action peculiarities and pharmacokinetics of novel fluoroquinolones 98MI6. 

A fluorine atom in position 6 of the basic structure of quinolones enhances the antimicrobial activity considerably. All widely used quinolones are fluorinated in position 6 and the term fluoroquinolones is often used to describe these drugs. However, some new quinolones with similar antimicrobial activity are not fluorinated in position 6 (e.g. garenoxacin, PGE9262932) and therefore the term quinolones is more appropriate to describe this group of antimicrobial agents. 

Hooper DC(2001) Mechanism of action of antimicrobials focus on fluoroquinolones. Clin Infect Dis 32 (Suppl 1) S9-S15... 

Allopurinol, barbiturates, benzodiazepines, captopril, carbamazepine, erythromycin, fluoroquinolones, isoniazid, NSAIDs, penicillins, phenothiazines, phenytoin, rifampin, sulfonamides antimicrobials, and tetracyclines... 

Amantadine, amiodarone, barbiturates, benzodiazepines, carbamazepine, chlorpromazine, fluoroquinolones, furosemide, NSAIDs, promethazine, psoralens, quinidine, simvastatin, sulfonamide antimicrobials, sulfonylureas, tetracyclines, and thiazides... 

Patients with complicated typhoid fever (i.e., metastatic foci, ileal perforation, etc.) should receive parenteral therapy with ciprofloxacin 400 mg twice daily or ceftriaxone 2000 mg once daily. Antimicrobial therapy can be completed with an oral agent after initial control of the symptoms of typhoid fever. In persons with AIDS and a first episode of Salmonella bacteremia, a longer duration of antibiotic therapy (1-2 weeks of parenteral therapy followed by 4 weeks of oral fluoroquinolone) is recommended to prevent relapse of bacteremia. 

Correct timing of antibiotic administration is imperative to preventing SSI. The National Surgical Infection Prevention Project recommends infusing antimicrobials for surgical prophylaxis within 60 minutes of the first incision. Exceptions to this rule are fluoroquinolones and vancomycin, which can be infused 120 minutes prior to avoid infusion-related reactions.1 No consensus has been reached on whether the infusion should be complete prior to the first incision. However, if a proximal tourniquet is used, antibiotic administration should be complete prior to inflation. 

Prophylactic antimicrobials should be started within an hour of the first incision to optimize patient outcomes. Exceptions to this include vancomycin and fluoroquinolones. 

Absorption of antimicrobial agents such as fluoroquinolones and tetracyclines that can be bound by divalent and trivalent cations potentially could be compromised by administration with EN formulas containing these cations. The fluoroquinolones (e.g., levofloxacin and ciprofloxacin) have been best studied in this regard, and results of studies are not consistent. Mechanisms for an interaction between fluoroquinolones and EN formulas other than chelation by cations have been postulated.40 Some institutions hold tube feedings for 30 to 60 minutes or more before and after enteral dosages of fluoroquinolones. Because ciprofloxacin absorption has been shown to be decreased with jejunal administration, this drug probably should not be given by jejunal tube.41... 

Antimicrobial agents as well as macrolide antibiotics and fluoroquinolones used in human and veterinary medicine are of particular interest due to their potential for... 

Although not reviewed in detail here, C. jejuni and C. coli are another major cause of inflammatory colitis that may be complicated by Guillain-Barre syndrome or reactive arthritis. In addition, their resistance to antimicrobials (particularly to quinolones) is increasing. In the United States, fluoroquinolone resistance of C. jejuni rose from 13% in 1997 to 18% in 1999 [112],... 

Animal and human studies support the use of antibiotics for the prevention of infectious morbidity and mortality in severe ANP. The most effective antimicrobial agents are the fluoroquinolones, imipenem-cilastatin, and metronidazole, which achieve adequate penetration into pancreatic juice and necrotic tissue and inhibit the growth of enteric bacteria. Although a recent meta-analysis [185] suggested that prophylactic antibiotic administration reduces sepsis and mortality and this approach has been recommended by recent guidelines and consensus state-... 

Integration of both pharmacokinetic and pharmacodynamic properties of an agent is important when choosing antimicrobial therapy to ensure efficacy and prevent resistance. Antibiotics may demonstrate concentration-dependent (aminoglycosides and fluoroquinolones) or time-depen-dent (/l-1 acta ms) bactericidal effects. 

Approximately 30% to 40% of H. influenzae are ampicillin resistant. For this reason, many clinicians use a third-generation cephalosporin (cefotaxime or ceftriaxone) for initial antimicrobial therapy. Once bacterial susceptibilities are available, ampicillin may be used if the isolate proves ampicillin sensitive. Cefepime and fluoroquinolones are suitable alternatives regardless of /1-lactamase activity. 

The majority of patients can be managed with oral antimicrobial agents, such as trimethoprim-sulfamethoxazole or the fluoroquinolones (ciprofloxacin, levofloxacin). When IV treatment is necessary, IV to oral sequential therapy with trimethoprim-sulfamethoxazole or a fluoroquinolone, such as ciprofloxacin or ofloxacin, would be appropriate. 

Tendon rupture/Tendinitis Ruptures of the shoulder, hand, and Achilles tendons that required surgical repair or resulted in prolonged disability have been reported with fluoroquinolone antimicrobials. 

Olsen, K.M., Gentry-Nielsen, M., Yue, M., Snitily, M.U. and Preheim, L.C. (2006) Effect of ethanol on fluoroquinolone efficacy in a rat model of pneumococcal pneumonia. Antimicrobial Agents and Chemotherapy, 50, 210-219. 

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