Pharmacodynamics of Fluoroquinolones

Abstract

Fluoroquinolones are a ubiquitous class of broad-spectrum antibacterials used to treat a multitude of bacterial infections in both the inpatient and outpatient settings. Pharmacodynamic research has played an integral role in the drug development and approval process for fluoroquinolones. There exists a wealth of fluoroquinolone pharmacodynamic literature and, despite considerable heterogeneity among studies, the results are almost universally the same: f-AUC24/MIC ratio is most predictive of microbiologic and clinical efficacy; >30 for gram-positive and >125 for gram-negative organisms. However, rising rates of fluoroquinolone resistance, particularly among gram-negative pathogens, may challenge these established pharmacodynamic indices. This chapter discusses the pharmacodynamics of fluoroquinolones with particular focus on the commonly used agents in current clinical practice: ciprofloxacin, levofloxacin, and moxifloxacin.