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Antimicrobial selection for community-acquired lower respiratory tract infections in the 21st century: a review of gemifloxacin.
Int J Antimicrob Agents. 2004 Jun; 23(6):533-46.IJ

Abstract

Community-acquired lower respiratory tract infections (LRTIs) are more prevalent in the elderly than in children and younger adults and form a significant proportion of all consultations and hospital admissions in this older age group. Furthermore, in a world of increasing life expectancy the trend seems unlikely to be reversed. Antimicrobial treatment of community-acquired pneumonia (CAP) must cover Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and in many circumstances should also cover the intracellular (atypical) pathogens. In contrast, acute exacerbations of chronic bronchitis (AECB) are mainly associated with H. influenzae and S. pneumoniae and not with atypical bacteria: in severe cases, other Gram-negative bacteria may be involved. Frequently in LRTIs, the aetiology of the infection cannot be identified from the laboratory specimens and treatment has to be empirical. In such situations it is important to not only to use an antibiotic that covers all likely organisms, but also one that has good activity against these organisms given the local resistance patterns. Gemifloxacin is a new quinolone antibiotic that targets pneumococcal DNA gyrase and topoisomerase IV and is highly active against S. pneumoniae including penicillin-, macrolide- and many ciprofloxacin-resistant strains, as well as H. influenzae and the atypical pathogens. In clinical trials in CAP and AECB, gemifloxacin has been shown to be as effective a range of comparators and demonstrated an adverse event profile that was in line with the comparator agents. In one long-term study in AECB significantly more patients receiving gemifloxacin than clarithromycin remained free of recurrence after 26 weeks. The improved potency, broad spectrum of activity and proven clinical and bacteriological efficacy and safety profile should make it a useful agent in the 21st century battle against community-acquired LRTIs.

Authors+Show Affiliations

Department of Pathology, Hershey Medical Center, P.O. Box 850, Hershey, PA 17033, USA. pappelbaum@psu.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15194123

Citation

Appelbaum, P C., et al. "Antimicrobial Selection for Community-acquired Lower Respiratory Tract Infections in the 21st Century: a Review of Gemifloxacin." International Journal of Antimicrobial Agents, vol. 23, no. 6, 2004, pp. 533-46.
Appelbaum PC, Gillespie SH, Burley CJ, et al. Antimicrobial selection for community-acquired lower respiratory tract infections in the 21st century: a review of gemifloxacin. Int J Antimicrob Agents. 2004;23(6):533-46.
Appelbaum, P. C., Gillespie, S. H., Burley, C. J., & Tillotson, G. S. (2004). Antimicrobial selection for community-acquired lower respiratory tract infections in the 21st century: a review of gemifloxacin. International Journal of Antimicrobial Agents, 23(6), 533-46.
Appelbaum PC, et al. Antimicrobial Selection for Community-acquired Lower Respiratory Tract Infections in the 21st Century: a Review of Gemifloxacin. Int J Antimicrob Agents. 2004;23(6):533-46. PubMed PMID: 15194123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial selection for community-acquired lower respiratory tract infections in the 21st century: a review of gemifloxacin. AU - Appelbaum,P C, AU - Gillespie,S H, AU - Burley,C J, AU - Tillotson,G S, PY - 2004/6/15/pubmed PY - 2005/2/3/medline PY - 2004/6/15/entrez SP - 533 EP - 46 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 23 IS - 6 N2 - Community-acquired lower respiratory tract infections (LRTIs) are more prevalent in the elderly than in children and younger adults and form a significant proportion of all consultations and hospital admissions in this older age group. Furthermore, in a world of increasing life expectancy the trend seems unlikely to be reversed. Antimicrobial treatment of community-acquired pneumonia (CAP) must cover Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, and in many circumstances should also cover the intracellular (atypical) pathogens. In contrast, acute exacerbations of chronic bronchitis (AECB) are mainly associated with H. influenzae and S. pneumoniae and not with atypical bacteria: in severe cases, other Gram-negative bacteria may be involved. Frequently in LRTIs, the aetiology of the infection cannot be identified from the laboratory specimens and treatment has to be empirical. In such situations it is important to not only to use an antibiotic that covers all likely organisms, but also one that has good activity against these organisms given the local resistance patterns. Gemifloxacin is a new quinolone antibiotic that targets pneumococcal DNA gyrase and topoisomerase IV and is highly active against S. pneumoniae including penicillin-, macrolide- and many ciprofloxacin-resistant strains, as well as H. influenzae and the atypical pathogens. In clinical trials in CAP and AECB, gemifloxacin has been shown to be as effective a range of comparators and demonstrated an adverse event profile that was in line with the comparator agents. In one long-term study in AECB significantly more patients receiving gemifloxacin than clarithromycin remained free of recurrence after 26 weeks. The improved potency, broad spectrum of activity and proven clinical and bacteriological efficacy and safety profile should make it a useful agent in the 21st century battle against community-acquired LRTIs. SN - 0924-8579 UR - https://www.unboundmedicine.com/medline/citation/15194123/Antimicrobial_selection_for_community_acquired_lower_respiratory_tract_infections_in_the_21st_century:_a_review_of_gemifloxacin_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924857904000913 DB - PRIME DP - Unbound Medicine ER -