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REVISION DE FLUOROQUINOLONAS EN LAS INFECCIONES DEL TRACTO RESPIRATORIO

(especial para SIIC © Derechos reservados)
Las fluoroquinolonas son drogas importantes en el manejo de las infecciones extrahospitalarias del tracto respiratorio; las de última generación ofrecen beneficios en cuanto a su farmacocinética, farmacodinamia y mayor espectro de acción.
smithheather.jpg Autor:
Heather j. Smith
Columnista Experto de SIIC
Artículos publicados por Heather j. Smith
Coautor
George G. Zhanel* 
Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, and Departments of Medicine. Health Sciences Centre, Winnipeg, Manitoba, Canada*
Recepción del artículo
13 de Enero, 2004 		Primera edición
5 de Octubre, 2004 		Segunda edición, ampliada y corregida
7 de Junio, 2021

REVISION DE FLUOROQUINOLONAS EN LAS INFECCIONES DEL TRACTO RESPIRATORIO

Resumen
Las nuevas fluoroquinolonas (clinafloxacina, garenoxacina, gatifloxacina, gemifloxacina, grepafloxacina, levofloxacina, moxifloxacina, sitafloxacina, sparfloxacina y trovafloxacina) tienen excelente actividad contra aerobios gramnegativos y mejor actividad contra organismos grampositivos como Streptococcus pneumoniae y Staphylococcus aureus. Clinafloxacina, garenoxacina, gatifloxacina, gemifloxacina, moxifloxacina, sitafloxacina, sparfloxacina y trovafloxacina tienen mejor actividad contra anaerobios como Bacteroides fragilis. Generalmente, la garenoxacina muestra la mayor actividad contra patógenos atípicos como Chlamydophila pneumoniae y Micoplasma pneumoiae. Las nuevas fluoroquinolonas son agentes terapéuticos cada vez más importantes en el tratamiento de infecciones extrahospitalarias del tracto respiratorio ya que tienen amplio espectro, incluyendo S. pneumoniae resistente a penicilina y a macrólidos, parámetros farmacocinéticos superiores y buena eficacia clínica. Al aumentar el uso de las fluoroquinolonas se informó la aparición de resistencia. Los mecanismos de resistencia comprenden las mutaciones cromosómicas espontáneas en las enzimas blanco, menor acumulación de la droga en la célula bacteriana y eflujo. Es necesario usar las nuevas fluoroquinolonas a conciencia para limitar la aparición de resistencia y preservar esta clase de antibacterianos.

Palabras clave
Flouoroquinolonas


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A REVIEW OF FLUOROQUINOLONES IN RESPIRATORY TRACT INFECTIONS

Abstract
The newer fluoroquinolones (clinafloxacin, garenoxacin, gatifloxacin, gemifloxacin, grepafloxacin, levofloxacin, moxifloxacin, sitafloxacin, sparfloxacin, and trovafloxacin) provide excellent activity against gram-negative aerobes and show improved activity against gram-positive organisms such as Streptococcus pneumoniae and Staphylococcus aureus. Clinafloxacin, garenoxacin, gatifloxacin, gemifloxacin, moxifloxacin, sitafloxacin, sparfloxacin, and trovafloxacin display improved activity against anaerobes such as Bacteroides fragilis. Generally, garenoxacin displays the highest activity against atypical pathogens such as Chlamydophila pneumoniae and Mycoplasma pneumoniae. The newer fluoroquinolones are increasingly important therapeutic agents in the treatment of community-acquired respiratory tract infections as they offer broad-spectrum activity, including penicillin and macrolide resistant S. pneumoniae, superior pharmacokinetic parameters, and good clinical efficacy. As use of fluoroquinolones increases, resistance development has been reported. Spontaneous chromosomal mutations in target enzymes, decreased accumulation of drug in the bacterial cell, and efflux comprise the mechanisms of fluoroquinolone resistance. Conscientious use of the newer fluoroquinolones is necessary in order to limit resistance development and preserve this class of antibacterial.


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Especialidades
Principal: Farmacología, Infectología
Relacionadas: Medicina Interna, Neumonología



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