Can you explain the significant clinical differences among the quinolones in their effectiveness in the treatment of pneumonia?
The real issue is how potent particular agents are against strep pneumonia as well as the risk involved. The dynamic of the drugs – how quickly they’re absorbed and how quickly they’re eliminated – appears pretty much the same for the once-daily drugs, which include levofloxacin, gatifloxacin, and moxifloxacin. However, differences in effectiveness and risk of resistance come from the minimal inhibitory concentration (MIC), which is the level at which the drug effectively kills bacteria. It’s much lower with moxifloxacin (.12mg/ml), intermediate with gatifloxacin (.5mg/ml), and fairly high with levofloxacin (1 or 2). A drug with a low MIC (moxifloxacin) is much better than one with a much higher MIC (levofloxacin). Why is there a controversy among physicians as to the proper course of treatment for acute tracheal bronchitis, and what is your preferred treatment for this infection? There was an effort in the United States about six or eight years ago to develop a national recommendation
