In recent years, synthetic antibacterial drugs have been increasingly used to treat various infections. This is due to the fact that many microorganisms develop resistance to antibiotics of natural origin. In addition, infectious diseases are becoming more severe, and it is not always possible to immediately determine the pathogen. Therefore, there is an increasing need for broad-spectrum antibacterial drugs, to which most microorganisms would be sensitive. One of the groups of the most effective drugs with such properties are fluoroquinolones. These preparations are obtained synthetically and have been widely known since the 80s of the 20th century. The clinical results of these agents have proven to be more effective than most known antibiotics.
What is the fluoroquinolone group
Antibiotics are drugs that have antimicrobial activity and most often have a naturalorigin. Formally, fluoroquinolones are not antibiotics. These are drugs of synthetic origin obtained from quinolones by adding fluorine atoms. Depending on their number, they have different efficiency and withdrawal period.
Once in the body, drugs of the fluoroquinolone group are distributed to all tissues, getting into fluids, bones, penetrating the placenta and the blood-brain barrier, as well as into bacterial cells. They have the ability to suppress the work of the main enzyme of microorganisms, without which DNA synthesis stops. This unique action leads to the death of bacteria.
Because these drugs are rapidly distributed throughout the body, they are more effective than most other antibiotics.
What microorganisms are fluoroquinolones active against
These are broad-spectrum drugs. It is believed that they are effective against most gram-positive and gram-negative bacteria, mycoplasmas, chlamydia, mycobacterium tuberculosis, and some protozoa. They destroy intestinal, Pseudomonas aeruginosa and Haemophilus influenzae, pneumococci, salmonella, shigella, listeria, meningococci and others. Intracellular microorganisms are also sensitive to them, which are difficult to cope with other drugs.
Only various fungi and viruses, as well as causative agents of syphilis, are insensitive to these drugs.
The benefit of using these drugs
Many severe and mixed infections can only be treated with fluoroquinolones. drugs,used for this in the past, are now increasingly becoming ineffective. And fluoroquinolones, in comparison with them, are more easily tolerated by patients, are quickly absorbed, and microorganisms cannot yet develop resistance to them. In addition, drugs in this group have other benefits:
- destroy bacteria, not weaken them;
- have a wide spectrum of action;
- penetrate into all organs and tissues;
- prevent septic shock;
- may be combined with other antibacterial drugs;
- have a long withdrawal period, which increases their effectiveness;
- rarely cause side effects.
How do fluoroquinolones work
Antibiotics are drugs that cause many side effects. And now many more microorganisms have become insensitive to such agents. Therefore, fluoroquinolones have become an excellent alternative to antibiotics in the treatment of infectious diseases. They have the unique ability to stop the reproduction of bacterial cells, which leads to their final death. This may explain the high efficacy of drugs of the fluoroquinolone group. The features of their action also include high bioavailability. They penetrate into all tissues, organs and fluids of the human body in 2-3 hours. These drugs are excreted mainly in the urine. And much less likely to cause side effects than antibiotics.
Indications for use
Antibacterial drugs of the fluoroquinolone group are widelyare used for nosocomial infections, severe infectious diseases of the respiratory tract and genitourinary system. Even such serious infections as anthrax, typhoid fever, salmonellosis, are easily treatable. They can replace most antibiotics. Fluoroquinolones are effective in treating the following conditions:
- chlamydia;
- gonorrhea;
- infectious prostatitis;
- cystitis;
- pyelonephritis;
- typhoid;
- dysentery;
- salmonellosis;
- pneumonia or chronic bronchitis;
- TB.
Instructions for using these drugs
Fluoroquinolones are most commonly available as oral tablets. But there is a solution for intramuscular injection, as well as drops in the eyes and ears. To obtain the desired therapeutic effect, it is necessary to follow all the doctor's recommendations on the dosage and features of taking the drugs. Tablets must be taken with water. It is important to maintain the required interval between taking two doses. If it happens that one dose is missed, you need to take the medicine as soon as possible, but not at the same time as the next dose.
When taking drugs of the fluoroquinolone group, you must follow the doctor's recommendations about their compatibility with other drugs, because some of them can both reduce the antibacterial effect and increase the possibility of side effects. It is not recommended to stay in direct sunlight for a long time during treatment.
Special instructions for admission
Fluoroquinolones are now considered the safest bactericidal agents. These drugs are prescribed to many categories of patients who are contraindicated in other antibiotics. However, there are certain limitations to their use. Fluoroquinolones are prohibited in such cases:
- children under 3 years old, and for some new generation drugs - up to 2 years old, but in childhood and adolescence they are used only in extreme cases;
- during pregnancy and breastfeeding;
- with atherosclerosis of cerebral vessels;
- with individual intolerance to the components of the drugs.
When prescribing fluoroquinolones together with anti-acid agents, their effectiveness is reduced, so a break of several hours between them is needed. If you use these drugs together with methylxanthines or iron preparations, then the toxic effect of quinolones increases.
Possible side effects
Fluoroquinolones are the most easily tolerated of all antibacterial agents. These drugs can occasionally cause only such side effects:
- abdominal pain, heartburn, bowel disorders;
- headaches, dizziness;
- sleep disorders;
- cramps, trembling muscles;
- vision or hearing loss;
- tachycardia;
- impaired liver or kidney function;
- fungal diseases of the skin and mucous membranes;
- Increased sensitivity to ultraviolet radiation.
Classification of fluoroquinolones
Now there are four generations of drugs in this group.
They began to be synthesized in the 60s, but they gained fame only at the end of the century. There are 4 groups of fluoroquinolones depending on the time of appearance and effectiveness.
- First generation are products with low efficacy against Gram-positive bacteria. These fluoroquinolones include preparations containing oxolinic acid or nalidixic acid.
- Second generation drugs are active against bacteria that are insensitive to penicillins. They also act on atypical microorganisms. These fluoroquinolones are often used for severe infections of the respiratory tract and digestive tract. Drugs in this group include the following: Ciprofloxacin, Ofloxacin, Lomefloxacin and others.
- 3rd generation fluoroquinolones are also called respiratory fluoroquinolones, as they are especially effective against infections of the upper and lower respiratory tract. These are Sparfloxacin and Levofloxacin.
- 4 generation of drugs in this group appeared recently. They are active against anaerobic infections. So far, only one drug has been distributed - Moxifloxacin.
1st and 2nd generation fluoroquinolones
The first mention of the drugs of this group can be found in the 60s of the 20th century. At first, such fluoroquinolones were used against infections of the genital tract and intestines. Drugs, the list of which is now known only to doctors, since they are alreadyalmost never used, had low efficiency. These are drugs based on nalidixic acid: Negram, Nevigramone. These first generation drugs were called quinolones. They caused many side effects, and many bacteria were insensitive to them.
But research on these drugs continued, and 20 years later, 2nd generation fluoroquinolones appeared. They got their names due to the introduction of fluorine atoms into the quinolone molecule. This increased the effectiveness of the drugs and reduced the number of side effects. Second-generation fluoroquinolones include:
- Ciprofloxacin, also known as Ciprobay or Cyprinol;
- "Norfloxacin", or "Nolicin".
- Ofloxacin, which can be purchased under the name Ofloxin or Tarivid.
- "Pefloxacin", or "Abactal".
- "Lomefloxacin", or "Maksakvin".
3rd and 4th generation drugs
Research on these drugs continues. And now the most effective are modern fluoroquinolones. The list of drugs of the 3rd and 4th generation is not yet very large, since not all of them have yet passed clinical trials and are approved for use. They have high efficiency and the ability to quickly penetrate into all organs and tissues. Therefore, these drugs are used for severe infections of the respiratory tract, genitourinary system, digestive tract, skin and joints. These include Levofloxacin, also known as Tavanic. It is effective even for the treatment of anthrax. For fourth generation drugsfluoroquinolones include "Moxifloxacin" (or "Avelox"), which is active against anaerobic bacteria. These new drugs eliminate most of the shortcomings of other drugs, are easier to tolerate by patients and are more effective.
Fluoroquinolones are one of the most effective treatments for severe infectious diseases. But they can only be used after a doctor's prescription.
