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 is fluoroquinolones. These drugs are obtained synthetically and have been widely known since the 80s of the 20th century. The clinical results of the use of these drugs have proven that they are more effective than most known antibiotics.
What is a group of fluoroquinolones
Antibiotics are drugs that have antimicrobial activity and most often have a natural origin. Formally, fluoroquinolones are not antibiotics. These are synthetic drugs derived from quinolones by adding fluorine atoms. Depending on their quantity, they have different efficacy and elimination periods.
Once in the body, preparations of the fluoroquinolone group are distributed over all tissues, getting into fluids, bones, penetrating the placenta and 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 ceases. This unique action leads to the death of bacteria.
Since these drugs are quickly distributed throughout the body, they are more effective than most other antibiotics.
What microorganisms are fluoroquinolones active against?
These are drugs with a wide spectrum of action. It is believed that they are effective against most gram-positive and gram-negative bacteria, mycoplasmas, chlamydia, mycobacterium tuberculosis, some protozoa. They destroy the intestinal, Pseudomonas aeruginosa and Haemophilus influenzae, pneumococci, Salmonella, Shigella, Listeria, meningococcus and others. Intracellular microorganisms are also sensitive to them, which are difficult to cope with other drugs.
Only different fungi and viruses, as well as pathogens of syphilis, are insensitive to these drugs.
Advantage of using these drugs
Many severe and mixed infections can only be treated with fluoroquinolones. Drugs used for this before are now increasingly becoming ineffective. And fluoroquinolones in comparison with them are more easily tolerated by patients, rapidly absorbed, and microorganisms cannot yet develop resistance to them. In addition, drugs in this group have other advantages:
- destroy bacteria, but do not weaken them;
- have a wide spectrum of action;
- penetrate into all organs and tissues;
- prevent the development of septic shock;
- can be combined with other antibacterial drugs;
- have a long elimination period, which increases their effectiveness;
- rarely cause side effects.
What effect do fluoroquinolones have
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 property of stopping the reproduction of bacterial cells, which leads to their final death. This can explain the high efficiency of the fluoroquinolone group of drugs. 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 mainly excreted in the urine. And much less often than antibiotics cause side effects.
Indications for use
Antibacterial drugs of the fluoroquinolone group are widely used for nosocomial infections, severe infectious diseases of the respiratory tract and genitourinary system. Even serious infections such as anthrax, typhoid fever, salmonellosis, are easily treatable. They can replace most antibiotics. Fluoroquinolones are effective for the treatment of such diseases:
- chlamydosis;
- gonorrhea;
- infectious prostatitis;
- cystitis;
- pyelonephritis;
- typhoid fever;
- dysentery;
- salmonellosis;
- pneumonia or chronic bronchitis;
- tuberculosis.
Instructions for use of these drugs
Fluoroquinolones are most often available as oral tablets. But there is a solution for intramuscular administration, as well as drops in the eyes and ears. To get the desired therapeutic effect, it is necessary to comply with all the doctor's recommendations on the dosage and features of taking the drugs. Tablets must be washed down with water. It is important to maintain the necessary interval between taking two doses. If it so happens that once you missed the drug, you need to take the medicine as soon as possible, but not simultaneously with the next dose.
When taking drugs of the fluoroquinolone group, it is necessary to follow the doctor's recommendations regarding their compatibility with other drugs, because some of them can both reduce the antibacterial effect and increase the likelihood of side effects. It is not recommended during treatment for a long time to be in direct sunlight.
Special instructions for admission
Now the safest bactericidal agents are considered fluoroquinolones. These drugs are prescribed for many categories of patients who are contraindicated in other antibiotics. But still there are certain limitations to their use. Fluoroquinolones are prohibited in such cases:
- children under 3 years old, and for some preparations of a new generation - up to 2 years, but in childhood and adolescence they are used only in extreme cases;
- during pregnancy and lactation;
- with atherosclerosis of the vessels of the brain;
- with individual intolerance to the components of the drugs.
When prescribing fluoroquinolones together with anticidal agents, their effectiveness decreases, therefore, a break of several hours between them is needed. If you use these drugs along with methylxanthines or iron preparations, then the toxic effect of quinolones increases.
Possible side effects
Of all antibacterial agents, fluoroquinolones are most easily tolerated. These drugs can occasionally cause only such side effects:
- abdominal pain, heartburn, intestinal upset;
- headaches, dizziness;
- sleep disturbances;
- cramps, trembling muscles;
- decreased vision or hearing;
- tachycardia;
- impaired liver or kidney function;
- fungal diseases of the skin and mucous membranes;
- hypersensitivity 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. 4 groups of fluoroquinolones are distinguished depending on the time of appearance and effectiveness.
- The first generation is a low-efficiency drug against gram-positive bacteria. These fluoroquinolones include preparations containing oxolinic or nalidixic acid.
- Second-generation drugs are active against penicillin-insensitive bacteria. They also act on atypical microorganisms. Often with severe infections of the respiratory tract and digestive tract, these fluoroquinolones are used. Drugs in this group include: Ciprofloxacin, Ofloxacin, Lomefloxacin and others.
- 3rd generation fluoroquinolones are also called respiratory, as they are especially effective against upper and lower respiratory tract infections. These are Sparfloxacin and Levofloxacin.
- The 4th generation of drugs in this group has appeared recently. They are active against anaerobic infections. So far, only one drug has been distributed - Moxifloxacin.
Preparations of the 1st and 2nd generation of fluoroquinolones
The first mention of drugs of this group can be found in the 60s of the 20th century. At first, such fluoroquinolones were used against genital tract and intestinal infections. The drugs, the list of which is now known only to doctors, since they are almost never used, had low efficiency. These are drugs based on nalidixic acid: Negram, Nevigramon. These first-generation drugs were called quinolones. They caused many side effects, and many bacteria were insensitive to them.
But studies of these drugs continued, and after 20 years, 2 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. The second generation of fluoroquinolones include:
- “Ciprofloxacin”, also known as “Ciprobay” or “Ciprinol”;
- Norfloxacin, or Nolitsin.
- Ofloxacin, which can be purchased under the name Ofloxin or Tarivid.
- "Pefloxacin", or "Abactal."
- Lomefloxacin, or Maksakvin.
Preparations 3 and 4 generations
Research on these drugs has continued. And now modern fluoroquinolones are considered the most effective. The list of drugs of the 3rd and 4th generation is still not very large, since not all have 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. The fourth generation of fluoroquinolones includes Moxifloxacin (or Avelox), which is active against anaerobic bacteria. These new remedies are devoid of most of the shortcomings of other drugs, are easier to tolerate by patients and more effective.
Fluoroquinolones are one of the most effective treatments for severe infectious diseases. But they can be used only after the appointment of a doctor.