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Vol. 47, No. 6, 2001
Issue release date: December 2001
Chemotherapy 2001;47:409–414

Differences between Two New Quinolones (Gemifloxacin and Trovafloxacin) and Ciprofloxacin in Their Concentration-Dependent Killing of Streptococcus pneumoniae

Joyanes P. · Pascual A. · Giménez M.J. · García I. · Aguilar L. · Perea E.
aMicrobiology Department, School of Medicine, University of Seville, bMedical Department, SmithKline Beecham Pharmaceuticals (GlaxoSmithKline), Madrid, Spain

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Background: Ciprofloxacin resistance influences the in vitro effect of new quinolones on Streptococcus pneumoniae.Methods: The early (over 3 h) in vitro bactericidal activity of gemifloxacin, trovafloxacin and ciprofloxacin was explored by time-kill tests against two ciprofloxacin-susceptible (MIC = 0.5 and 1 µg/ml) and two ciprofloxacin-resistant (MIC = 16 µg/ml) S. pneumoniae strains. Results: At subinhibitory concentrations (0.5 × MIC) and inhibitory concentrations (1 × MIC), only gemifloxacin exhibited significant bactericidal activity with, respectively, approximately 85 and approximately 95% decrease in the initial inoculum of the two ciprofloxacin-resistant strains. At concentrations similar to peak serum concentrations (1.5, 3 and 2.5 µg/ml for gemifloxacin, trovafloxacin and ciprofloxacin, respectively) after standard doses, only gemifloxacin exhibited an approximately 99.9% (3 log10) reduction in the initial inoculum for the four strains tested, regardless of their susceptibility to ciprofloxacin. No bactericidal activity was exhibited for the other two quinolones against the ciprofloxacin-resistant strains. Conclusions: Gemifloxacin offers high early bactericidal activity at concentrations similar to peak and trough levels, theoretically preventing regrowth over the dosing interval, and thus dealing with the problem of ciprofloxacin resistance in S. pneumoniae.

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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  1. Lorian V: Medical relevance of low concentrations of antibiotics. J Antimicrob Chemother 1993;31:137–148.
  2. Carbon C: Significance of tissue levels for prediction of antibiotic efficacy and determination of dosage. Eur J Clin Microbiol Infect Dis 1990;9:510–516.
  3. Odenholt-Tornqvist I, Löwdin E, Cars O: Pharmacodynamic effects of subinhibitory concentrations of beta-lactam antibiotics in vitro. Antimicrob Agents Chemother 1991;35:1834–1839.
  4. Briceland LL, Pasko MT, Mylotte JM: Serum bactericidal rate as a measure of antibiotic interactions. Antimicrob Agents Chemother 1987;31:679–685.
  5. Mattie H: Kinetics of antimicrobial action. Rev Infect Dis 1981;3:19–27.

    External Resources

  6. Amsterdam D: Susceptibility testing of antimicrobials in liquid media; in Lorian V (ed): Antibiotics in Laboratory Medicine, ed 4. Baltimore, Williams & Wilkins, 1996, pp 52–111.
  7. Woodnutt G: Pharmacodynamics to combat resistance. J Antimicrob Chemother 2000;46:25–31.
  8. Craig WA: Pharmacokinetic/pharmacodynamic parameters: Rationale for antibacterial dosing of mice and men. Clin Infect Dis 1998;26:1–12.
  9. Fuentes F, Giménez MJ, Marco F, Alou L, Aguilar L, Prieto J: In vitro susceptibility to gemifloxacin and trovafloxacin of Streptococcus pneumoniae strains exhibiting decreased susceptibility to ciprofloxacin. Eur J Clin Microbiol Infect Dis 2000;19:137–139.

    External Resources

  10. Baquero F, García-Rodríguez JA, García de Lomas J, Aguilar L: Antimicrobial resistance of 1,113 Streptococcus pneumoniae isolates from patients with respiratory tract infections in Spain: Results of a 1-year (1996–1997) multicenter surveillance study. The Spanish Surveillance Group for Respiratory Pathogens. Antimicrob Agents Chemother 1999;43:357–359.
  11. García-Rey C, Aguilar L, Baquero F on behalf of the Spanish Surveillance Group for Respiratory Pathogens: Influence of different factors on the ciprofloxacin resistance prevalence of Streptococcus pneumoniae in Spain. Antimicrob Agents Chemother 2000;44:3481–3482.
  12. National Committee for Clinical Laboratory Standards: Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; approved standard, ed 5. NCCLS document M7-A4. Wayne, National Committee for Clinical Laboratory Standards, 2000.
  13. Allen A, Bygate E, Oliver S, Johnson M, Ward C, Cheon AJ, Choo YS, Kim IC: Pharmacokinetics and tolerability of gemifloxacin (SB265805) after administration of single oral doses to healthy volunteers. Antimicrob Agents Chemother 2000;44:1604–1608.
  14. Höffken G, Lode H, Prinzing C, Borner K, Koeppe P: Pharmacokinetics of ciprofloxacin after oral and parenteral administration. Antimicrob Agents Chemother 1985;27:375–379.
  15. Wise R, Mortiboy D, Child J, Andrews JM: Pharmacokinetics and penetration into inflammatory fluid of trovafloxacin (CP-99,219). Antimicrob Agents Chemother 1996;40:47–49.
  16. Amsterdam D: The MIC: Myth and reality. Antimicrob Newsl 1992;8:9–16.
  17. Gómez-Lus ML, Aguilar L, Martín M, Giménez MJ, Martínez P, Prieto J: Intracellular and extracellular killing of a penicillin-resistant, serotype-9 strain of Streptococcus pneumoniae by polymorphonuclear leukocytes in the presence of sub-inhibitory concentrations of clavulanic acid. J Antimicrob Chemother 1997;40:142–144.

    External Resources

  18. Amsterdam D: Assessing cidal activity of antimicrobial agents: Problems and pitfalls. Antimicrob Newsl 1990;7:49–56.
  19. Eagle H, Fleischmann R, Nussekman AD: Effect of schedule of administration on the therapeutic efficacy of penicillin: Importance of the aggregate time penicillin remains at effective bactericidal levels. Am J Med 1950;9:280–299.

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