Oral
quinolones such as
ciprofloxacin are promising agents in the treatment of serious bronchopulmonary
infections due to susceptible gram-negative micro-organisms such as Haemophilus influenzae, Branhamella catarrhalis, Klebsiella pneumoniae and even Pseudomonas aeruginosa. Their moderative activity against Streptococcus pneumoniae may limit the use of these agents in the treatment of acute exacerbations of
chronic bronchitis and in the empiric management of community-acquired
bacterial pneumonia. Further prospectively designed studies are needed to address this issue. The ability of
quinolones to effectively penetrate bronchial mucosa and to be concentrated within macrophages may afford additional advantage to these agents. They should not be used as a sole agent in the treatment of
aspiration pneumonia nor anaerobic pleuropulmonary disease.
Quinolones are very active in experimental models of
Legionnaire's disease and deserve further clinical study.
Ciprofloxacin is a promising alternative to standard parenteral drugs in the management of
Pseudomonas aeruginosa infections in adults with
cystic fibrosis. The potential for drug interactions with
theophylline must be kept in mind for patients on both of these drugs.