Drug-Related Muscular Pain
Kohlstadt Ingrid, Cintron Kenneth in Metabolic Therapies in Orthopedics, Second Edition, 2018
Quinolone antibiotics such as levofloxacin, ciprofloxacin and moxifloxacin are broad spectrum antibiotics that are effective against both gram positive and gram negative bacteria. They are often used to treat urinary tract infections (UTIs). Other antibiotics such as sulfamethoxazole-trimethoprim, cephalexin, and nitrofurantoin monohydrate are also frequently used to treat UTIs. First generation quinolones and fluoroquinolones can produce cartilage lesions, especially in weight-bearing joints, that can in rare instances lead to tendinopathies such as tendonitis and tendon rupture.3 Tendon rupture can occur even after a single dose of a quinolones with the risk beginning at 48 hours after starting treatment and lasting over several months after the completion of treatment. Tendinopathies due to quinolones are especially a concern in sports medicine where patients may exert themselves more and increase their risk of tendon rupture after taking a quinolone antibiotic. There have been reports of non-erosive arthropathies that are involved with the lower extremities and often occur in patients with cystic fibrosis. Articular symptoms generally appear within the first two weeks of the initiation of therapy, though late onset is possible and does not need to start within two weeks of beginning the antibiotic therapy.3 These effects often occur in younger patients; therefore, fluoroquinolones are contraindicated in children and adolescents. This drug class is also contraindicated during pregnancy and lactation due to risk of the mother passing the drug through the placenta.3
Infections of the Skin, Soft Tissues, Joints and Bone
Keith Struthers in Clinical Microbiology, 2017
In the non-septic patient, the orthopaedic team will usually initiate a broad-spectrum combination of vancomycin and meropenem after operation, unless the immediate or previous microbiology results direct otherwise. Once an organism is identified, the necessary narrow-spectrum antibiotics are used. As most infections are caused by gram-positive bacteria, antibiotics for relevant organisms identified include benzylpenicillin, flucloxacillin, vancomycin, teicoplanin and daptomycin. Rifampicin is often added as a second agent, especially as it is considered to have better penetration into biofilm. The quinolones such as ciprofloxacin are used to treat infections caused by susceptible gram-negative bacteria, as their oral bioavailability and tissue penetration is good. In certain patients where the prosthesis cannot be removed, long-term suppressive antibiotic treatment is given.
New Developments in Drug Treatment
Peter D O Davies, Stephen B Gordon, Geraint Davies in Clinical Tuberculosis, 2014
Quinolones are synthetic antibiotics originally identified as by-products of chloroquine synthesis [81]. Since the introduction of nalixidic acid for the treatment of urinary tract infections in 1967, quinolones have been extensively developed to improve their pharmacokinetics and to broaden their spectrum of activity [82]. Lately, this focused on developing fluoroquinolones for the treatment of respiratory tract infections caused by Streptococcus pneumonia and other pathogens. Some of these fluoroquinolones were found to be effective against M. tuberculosis and have already become the most important drugs in regimens to treat MDR-TB. For example, a recent systematic review of 9153 MDR-TB patients found the use of quinolones was strongly associated with successful treatment outcome [4]. Their excellent oral bioavailability and bactericidal action, lack of cross-resistance with existing TB drugs and favourable safety profile have also resulted in them being evaluated in the treatment of drug-susceptible tuberculosis.
DFT based QSAR study on quinolone-triazole derivatives as antibacterial agents
Published in Journal of Receptors and Signal Transduction, 2022
Niloofar Ghasedi, Shahin Ahmadi, Sepideh Ketabi, Ali Almasirad
The accidental discovery of Nalidixic acid led to the development of a class of antibacterial drugs called fluoroquinolones. Today, quinolones are among the most important synthetic antibacterial agents, widely used in treating various infections. The clinical success of quinolones is due to features such as good bioavailability in oral administration, good tissue permeability, and relatively low toxicity. However, this widely used antibiotic class has been prone to resistance too. So there is the need to search for new representatives of this class, which have a potent antibacterial activity and the potential to overcome the bacterial resistance [2,3]. Hybrid molecules are chemical structures containing two or more structural domains with different biological functions and dual activities. Such hybrid molecules can overcome cross-drug resistance, create a broader range of effects, reduce toxicity, improve efficacy, and present new candidates with high potency against drug-resistant and drug-sensitive bacteria [1].
Anti-MRSA quinolones for acute bacterial skin and skin structure infection: a systematic review and meta-analysis of randomized controlled trials
Published in Expert Review of Anti-infective Therapy, 2022
Chien-Ming Chao, Teng-Song Weng, Yu-Hung Chen, Chih-Cheng Lai, Wei-Ting Lin
Moreover, this study investigated the usefulness of anti-MRSA quinolones for the treatment of patients with MRSA-associated ABSSSIs. We found that anti-MRSA quinolones result in a similar clinical and microbiological response as other anti-MRSA agents in patients with ABSSSIs caused by MRSA. These findings are supported by the potent in vitro activities of delafloxacin, levonadifloxacin, and acorafloxacin against MRSA, as reported in previous studies [26–31]. Remey et al investigated the minimum inhibitory concentration (MIC) of delafloxacin against 30 MRSA clinical isolates and showed that the MIC, MIC50, and MIC90 were 0.008–1, 0.03, and 0.5 mg/L, respectively [26]. Pfaller et al investigated the MIC of delafloxacin against 573 MRSA clinical isolates and showed that the MIC, MIC50, and MIC90 were ≤0.004–4, 0.06, and 0.5 mg/L, respectively [27]. A prospective, multicenter surveillance study in India demonstrated that levonadifloxacin exhibits potent activity against MRSA, with MIC50 and MIC90 of 0.5 and 1 mg/L [28]. Similarly, the MIC, MIC50, and MIC90 of acorafloxacin against 308 MRSA isolates were ≤0.12–4, 0.25 and 1 mg/L, respectively [30]. Furthermore, these three anti-MRSA quinolones exhibited potent activity against other commonly encountered gram-positive pathogens [26–28,30,31]. All these findings support the use of these anti-MRSA quinolones for the treatment of patients with ABSSSIs caused by MRSA.
Drug-delivering devices in the urinary tract: A systematic review
Published in Arab Journal of Urology, 2021
Panagiotis Kallidonis, Constantinos Adamou, Sara Villarrova Castillo, Despoina Liourdi, Evangelos Liatsikos, Dirk Lange
The antimicrobial effects of quinolones were studied in two articles [14,17]. Elayarajah et al. [14] used stents impregnated with a mixture of ofloxocin and ornidazole. Using a simplistic agar diffusion test they showed the impregnated stents to be effective at killing E. coli and S. epidermidis. In addition, they tested efficacy against preventing bacterial adhesion in artificial urine and found the number on the DES/DCS to be significantly lower compared to the conventional stent. Ma et al. [17] studied the characteristics and effiacy of three ciprofloxacin DES/DCS, differing in the composition of the antibiotic carrier. The stents remained in artificial urine for 120 days, over which time the coating degradation, antibiotic-release profile, the anti-bacterial activity, and cytotoxicity were assessed. It was found that ciprofloxacin release occured in three phases and was highly dependent on the degradation activity of the coating, except from the first 7 days (‘burst stage’). An inital burst release of antibiotics is important to ensure high enough concentrations to kill any introduced bacterial loads and prevent bacterial adhesion, colonisation and subsequent biofilm formation. Getting this amount right is critical, as the release of sub-optimal concentrations, especially over long periods of time, has a significant risk for inducing resistance. In general, it was shown that ciprofloxacin DES/DCS have good antibacterial activity against S. aureus and E. coli, and no cytotoxicity against human foreskin fibroblasts.
Related Knowledge Centers
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- Gram-Positive Bacteria
- Ciprofloxacin