Analysis on Influential Factors for Anti-Infection Efficacy of Fluoroquinolones


Objective: To investigate factors contributed to anti-infection efficacy of fluoroquinolones (FQNS), and ultimately to provide guidelines for the application of such drugs. Methods: Clinical data of 519 infected patients who were treated with fluoroquinolones were analyzed retrospectively. According to the therapeutic efficacy of the drugs, cases were divided into 3 groups: clinical inefficient, improved and cured. 11 potential factors were investigated. The data were analyzed through logistic regression analysis to determine the main factors which influence therapeutic effects. Results: Ordinal logistic regression revealed that age (OR = 0.979, 95% CI: 0.969, 0.989), a variety of medicine (moxifloxacin-OR = 3.465, 95% CI: 1.396, 8.601; levofloxacin-OR = 4.605, 95% CI: 1.971, 10.760; ciprofloxacin-OR = 3.220, 95% CI: 1.089, 9.552; compared to lomefloxacin) (levofloxacin-OR = 2.591, 95% CI: 1.130, 5.944; compared to fleroxacin) and site of infection (respiratory system-OR = 3.016, 95% CI: 1.737, 5.236; urological system-OR = 4.077, 95% CI: 1.981, 8.391; digestive system-OR = 3.740, 95% CI: 1.849, 7.565) are main factors which influence the efficacy. Conclusion: Fluoroquinolones are more effective in the treatment of bacterial infection within drug’s indications in young population. Variety, dosage and intervals of the drugs should be adjusted according to disease condition.

Share and Cite:

N. Wang, L. Zhu, X. Zhao and Y. Yang, "Analysis on Influential Factors for Anti-Infection Efficacy of Fluoroquinolones," Pharmacology & Pharmacy, Vol. 5 No. 1, 2014, pp. 129-138. doi: 10.4236/pp.2014.51018.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] G. Y. Lesher, E. J. Froelich, M. D. Gruett, J. H. Bailey and R. P. Brundage, “1,8-Naphthyridine Derivatives: A New Class of Chemotherapeutic Agents,” Journal of Medicinal and Pharmaceutical Chemistry, Vol. 5, No. 5, 1962, pp. 1063-1065.
[2] H. Koga, A. Itoh, S. Murayama, S. Suzue and T. Irikura, “Structure-Activity Relation-Ships of Antibacterial 6,7- and 7,8-Disubstituted 1-Alkyl-1,4-dihydro-4-oxoquinoline-3-carboxylic Acids,” Journal of Medicinal Chemistry, Vol. 23, No. 12, 1980, pp. 1358-1363.
[3] H. C. Neu, “Clinical Use of the Quinolones,” Lancet, Vol. 330, No. 8571, 1987, pp. 1319-1322.
[4] L. A. Mitscher, “Bacterial Topoisomerase Inhibitors: Quinolone and Pyridone Antibacterial Agents,” Chemical Reviews, Vol. 105, No. 2, 2005, pp. 559-592.
[5] H. J. Adam, D. J. Hoban, A. S. Gin and G. G. Zhanel, “Association between Fluoroquinolone Usage and a Dramatic Rise in Ciprofloxacin-Resistant Streptococcus pneumoniae in Canada, 1997-2006,” International Journal of Antimicrobial Agents, Vol. 34, No. 1, 2009, pp. 82-85.
[6] D. Yanagi, G. C. de Vries, D. Rahardjo, L. Alimsardjono, E. B. Wasito, I. De, et al., “Emergence of Fluoroquinolone-Resistant Strains of Salmonella enterica in Surabaya, Indonesia,” Diagnostic Microbiology and Infectious Disease, Vol. 64, No. 4, 2009, pp. 422-426.
[7] M. Mac Aogáin, M. J. Mooij, C. Adams, J. Clair and F. O’Gara, “Emergence of Extended-Spectrum β-Lactamase and Fluoroquinolone Resistance Genes among Irish Multidrug-Resistant Isolates,” Diagnostic Microbiology and Infectious Disease, Vol. 67, No. 1, 2010, pp. 106-109.
[8] C. M. Chang, T. L. Lauderdale, H. C. Lee, N. Y. Lee, C. J. Wu, P. L. Chen, et al., “Colonisation of Fluoroquinolone-Resistant Haemophilus influenzae among Nursing Home Residents in Southern Taiwan,” Journal of Hospital Infection, Vol. 75, No. 4, 2010, pp. 304-308.
[9] S. Jazayeri, M. H. Moshafi, L. Firoozpour, S. Emami, S. Rajabalian, M. Haddad, et al., “Synthesis and Antibacterial Activity of Nitroaryl Thiadiazole-Gatifloxacin Hybrids,” European Journal of Medicinal Chemistry, Vol. 44, No. 3, 2009, pp. 1205-1209.
[10] S. Lemaire, F. Van Bambeke and P. M. Tulkens, “Activity of Finafloxacin, a Novel Fluoroquinolone with Increased Activity at Acid pH, towards Extracellular and Intracellular Staphylococcus aureus, Listeria monocytogenes and Legionella pneumophila,” International Journal of Antimicrobial Agents, Vol. 38, No. 1, 2011, pp. 52-59.
[11] D. S. Billal, M. Hotomi, S. S. Yan, D. P. Fedorko, J. Shimada, K. Fujihara, et al., “Loss of Erythromycin Resistance Genes from Strains of Streptococcus pyogenes That Have Developed Resistance to Levofloxacin,” Diagnostic Microbiology and Infectious Disease, Vol. 64, No. 2, 2009, pp. 225-228.
[12] D. H. Zhao, Y. J. Li, S. M. Xie, M. Zhao and J. B. Yang, “Consideration for Clinical Efficacy Evaluation Criterion in Guidance for Clinical Trials of Antibacterial Agents in China,” Clinical Pharmacology & Therapeutics, Vol. 24, No. 6, 2008, pp. 564-565.
[13] H. M. Lode, “Rational Antibiotic Therapy and the Position of Ampicillin/Sulbactam,” Antimicrobial Agents, Vol. 32, No. 1, 2008, pp. 10-28.
[14] A. M. Noreddin, D. J. Hoban and G. G. Zhanel, “Comparison of Gatifloxacin and Levofloxacin Administered at Various Dosing Regimens to Hospitalised Patients with Community-Acquired Pneumonia: Pharmacodynamic Target Attainment Study Using North American Surveillance Data for Streptococcus pneumoniae,” International Journal of Antimicrobial Agents, Vol. 26, No. 2, 2005, pp. 120-125.
[15] L. R. Wiseman and J. A. Balfour, “Ciprofloxacin. A Review of Its Pharmacological Profile and Therapeutic Use in the Elderly,” Drugs & Aging, Vol. 4, No. 2, 1994, pp. 145-173.
[16] L. Thabet, M. Memmi, A. Turki and A. A. Messadi, “The Impact of Fluoroquinolones Use on Antibiotic Resistance in an Intensive Care Burn Department,” La Tunisie Médicale, Vol. 88, No. 10, 2010, pp. 696-699.
[17] H. Lode and M. Allewelt, “Role of Newer Fluoroquinolones in Lower Respiratory Tract Infections,” Journal of Antimicrobial Chemotherapy, Vol. 49, No. 5, 2002, pp. 709-712.
[18] J. Zhang, J. F. Xu, Y. B. Liu, Z. K. Xiao, J. A. Huang, B. Si, et al., “Population Pharmacokinetics of Oral Levofloxacin 500 mg Once-Daily Dosage in Community-Acquired Lower Respiratory Tract Infections: Results of a Prospective Multicenter Study in China,” Journal of Infection and Chemotherapy, Vol. 15, No. 5, 2009, pp. 293-300.
[19] R. Bellmann, P. Egger, W. Gritsch, R. Bellmann-Weiler, M. Joannidis, S. Dunzendorfer, et al., “Elimination of Levofloxacin in Critically Ill Patients with Renal Failure: Influence of Continuous Veno-Venous Hemofiltration,” International Journal of Clinical Pharmacology and Therapeutics, Vol. 40, No. 4, 2002, pp. 142-149.
[20] A. Forrest, M. Weir, K. I. Plaisance, G. L. Drusano, J. Leslie and H. C. Standiford, “Relationships between Renal Function and Disposition of Ciprofloxacin,” Antimicrobial Agents and Chemotherapy, Vol. 32, No. 10, 1988, pp. 1537-1540.
[21] H. Stass and J. Lettieri, “Pharmacokinetics of Moxifloxacin in Special Populations,” Drugs, Vol. 58, Suppl. 2, 1999, pp. 233-234.
[22] H. Ohtani, Y. Kinoshita, Y. Nagasaki, et al., “Dosage Adjustment of Quinolone Antibiotics and Angiotensin-Converting Enzyme Inhibitors in Patients with Renal Dysfunction,” International Journal of Clinical Pharmacology and Therapeutics, Vol. 44, No. 9, 2006, pp. 428-437.
[23] P. Mugnier, A. Taburet, P. Wyld, et al., “Pharmacokinetics of Sparfloxacin in Patients with Hepatic Failure,” 34th Interscience Conference on Antimicrobial Agents and Chemotherapy, Orlando, 4 October 1994
[24] G. L. Drusano, M. Weir, A. Forrest, K. Plaisance, T. Emm and H. C. Standiford, “Pharmacokinetics of Intravenously Administered Ciprofloxacin in Patients with Various Degrees of Renal Function,” Antimicrobial Agents and Chemotherapy, Vol. 31, No. 6, 1987, pp. 860-864.
[25] L. G. Gisclon, C. R. Curtin, R. R. Williams, et al., “The Pharmacokinetics of Levofloxacin in Subjects with Renal Impairment, and in Subjects Receiving Hemodialysis or Continuous Ambulatory Peritoneal Dialysis,” Program and Abstracts of the 36th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, 15-18 September 1996, Abstract A13.
[26] K. Vance-Bryan, D. Guay and J. Rotschafer, “Clinical Pharmacokinet-Ics of Ciprofloxacin,” Clinical Pharmacokinetics, Vol. 19, No. 6, 1990, pp. 434-461.
[27] D. M. Grasela, B. Christofalo, G. D. Kollia, G. Duncan, R. Noveck, J. A. Manning, Jr., et al., “Safety and Pharmacokinetics of a Single Oral Dose of Gatifloxacin in Patients with Moderate to Severe Hepatic Impairment,” Pharmacotherapy, Vol. 20, No. 6, 2000, pp. 87S-94S.
[28] J. Figueira-Coelho, O. Pereira, B. Picado, P. Mendonça, J. Neves-Costa and J. Neta, “Acute Hepatitis Associated with the Use of Levofloxacin,” Clinical Therapeutics, Vol. 32, No. 10, 2010, pp. 1733-1737.
[29] R. Verma, R. Dhamija, D. H. Batts, S. C. Ross and M. E. Loehrke, “Moxifloxacin Induced Fatal Hepatotoxicity in a 72-Year-Old Man: A Case Report,” Cases Journal, Vol. 2, 2009, p. 8063.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.