Be Cautious When Using Quinolone Antibiotics

Psychology of drug users often towards new generation drugs, especially antibiotics. Quinolon is one of the important antibiotics with broad spectrum of effect in the treatment of gram-negative and gram-positive aerobic bacteria. However, caution should be used.
The establishment of this group of antibiotics has brought great hope to fight dangerous bacteria that are increasingly resistant to familiar antibiotics. Quinolones are classified based on pharmacological properties and by time of discovery

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The first quinolones
These include non-fluorinated derivatives, typically nalidixic acid and cinoxacin, which have a narrow antibacterial spectrum that is only used to treat uncomplicated urinary tract infections.
Nalidixic acid (negram) was discovered by accident in 1962 during the preparation of cloroquin malaria. Later, people also put to use some drugs similar to puram, purin, eracine .



. Currently, the use of these drugs is limited by highly resistant bacteria.
The 2nd generation quinolones
The second generation quinolone antibiotic, also known as fluoroquinolone (FQ), characterized by the addition of fluorine atoms to the quinolon structure, was introduced in 1985.
Generation 2 drugs including ciprofloxacin, enoxacin, grepafloxacin, lomefloxacin, norfloxacin and ofloxacin have more advanced pharmacodynamics than the first generation drugs and are effective against many types of microorganisms that cause gram-negative infections and systemic effects.
Compare two types of quinolone antibiotics
Compared with the first-generation quinolones, FQs have fewer side effects and overcome rapidly resistant bacteria. Clinical uses include uncomplicated and complicated urinary tract infections and pyelonephritis, sexually transmitted infections, prostatitis, skin and soft tissue infections.
Some typical drugs, such as norfloxacin, were the first of their class to be marketed in 1986 and have the shortest elimination half-life among all existing FQs In general, the drug is intended to treat urinary tract infections because of its poor oral bioavailability.




Ciprofloxacin is a potent FQ and well penetrates into the bone, so it can substitute for oral antibiotics to treat osteomyelitis caused by sensitive bacteria.
Ofloxacin is the most intact renal drug.
Ciprofloxacin and ofloxacin are also second-generation FQ with wide indications and are available in oral, intravenous, eye, and ear drops to treat external and middle ear infections.
Currently, ciprofloxacin and ofloxacin are commonly used in the treatment of complicated tuberculosis in AIDS patients and in combination with other drugs in the treatment of drug-resistant tuberculosis. Enoxacin has the strongest impact on the liver metabolism of other drugs.
3rd generation quinolones
3rd generation quinolonbao antibiotics include gatifloxacin, levofloxacin, moxifloxacin and sparfloxacin. Levofloxacin is the levo isomer and is the more active component of the radiant ofloxacin compound (raxem). Generation 3 FQs have a broad spectrum against gram-positive bacteria, which are indicated in community pneumonia, acute sinusitis and exacerbation of chronic bronchitis.




Gatifloxacin is also licensed for the treatment of urinary tract infections and gonorrhea. Both gatifloxacin and levofloxacin are available in oral and intravenous form. Levofloxacin is also available in the form of eye drops to treat bacterial conjunctivitis.
4th generation quinolones
Quinolones 4th generation antibiotics include trovafloxacin, alatrofloxacin. Trovafloxacin is an oral active ingredient, while alatrofloxacin is a precursor to intravenous trovafloxacin.
Trovafloxacin has a pronounced anti-anaerobic effect while retaining the gram-negative and gram-positive activity of 3rd-generation FQs. They also have the same effect as ciprofloxacin.
Trovafloxacin is the first oral antibiotic to be used as prophylactic treatment for surgical patients because the blood concentration when taken orally is nearly equal to that of the injection.



It is restricted to use in serious, life-threatening infections or limb amputations, since the drug can cause serious side effects on the liver.
It is important not to combine FQ antibiotics with tetracycline antibiotics. Antacids (in gastric-duodenal ulcer), iron supplements and even vitamins along with mineral salts such as zinc and calcium can bind and reduce up to 90% of the oral bioavailability of quinolones.
Cationic and trivalent cationic drugs such as sucralfate containing aluminum ions, didanosin tablets containing buffers with aluminum and magnesium ions all reduce the bioavailability of ciprofloxacin and norfloxacin.
Be cautious when using quinolone antibiotics
FQs have relatively few side effects and toxicity. However, since cartilage malformations have been observed in young animals when quinolones have been used at doses many times greater than human doses, it is recommended not to use the drug for children under 16 years of age for fear of the drug's harmful effects. child's development.
In general, quinolones should not be given to children if they are not absolutely necessary.



Use this antibiotic only for children if there is no other alternative.
People also pay attention to the situation.

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