Fluoroquinolones

Introduction

Fluoroquinolones are a group of antibiotics that are particularly suitable for the treatment of so-called Gram-negative rod bacteria. Rod bacteria are all types of bacteria that look rather elongated under the microscope. Gram-negative refers to a characteristic that is revealed by a special staining method (Gram-staining).

Gram-negative rods are mostly bacteria that occur in the digestive tract (so-called enterobacteria). These can be treated particularly well by fluoroquinolones. Newer substances from the group of fluoroquinolones are also effective against other groups of bacteria. The fluoroquinolones are used as broad-spectrum antibiotics, for example as the first-choice remedy for urinary tract infections.

Indications

The indications for therapy with fluoroquinolones are manifold, as this is a class of antibiotics with a very broad spectrum of activity. The earliest active ingredients of fluoroquinolones are mainly suitable for the therapy of enterobacteria (bacteria found in the digestive tract). They are therefore often used for uncomplicated infections of the urinary tract, the bladder and possibly the genitals (for example, an infection of the prostate).

These infections are often caused by smear infections from the intestines and therefore often respond to fluoroquinolones. Severe gastrointestinal infections can also be treated with fluoroquinolones. If necessary, therapy with, for example, ciprofloxacin is also suitable for treating acute inflammation of the pancreas.

Later generations of fluoroquinolones have a significantly broader spectrum of action and can therefore also be used for infections of the respiratory tract or in the ear, nose and throat area. Bone and joint diseases caused by bacteria can also be treated with fluoroquinolones such as Levofloxacin. In addition, fluoroquinolones are also important in the treatment of so-called nosocomial infections (acquired in hospital/care units). These are often infections with resistant bacteria, which can often be treated well with fluoroquinolones such as moxifloxacin.

Active ingredient, effect

The term fluoroquinolone describes a group of antibiotics that kill bacteria. The active ingredients norfloxacin, ciprofloxacin, oflocazin, levofloxacin and moxifloxacin belong to the fluoroquinolones. The fluoroquinolones unfold their effect via a so-called gyrase inhibition.

Gyrase is an enzyme which is needed in bacteria to multiply the genetic material. The gyrase of the bacteria is also called topoisomerase II. By inhibiting this topoisomerase II, the bacteria can no longer copy their genetic material (= their DNA).

This inhibits the growth of the bacterial colony (bacteriostatic) and the bacteria then die (bactericidal). In addition to gyrase inhibition, other mechanisms of action of fluoroquinolones are also being discussed, since their good efficacy cannot be explained by gyrase inhibition alone. So far, however, no concrete mechanisms of action have been confirmed in experiments.

The mode of action of fluoroquinolones is particularly well established because the active ingredient is very tissue-bound. This property describes the ability of fluoroquinolones to spread particularly well in the tissue. They are therefore well suited for the treatment of many tissue infections, including bone.