Newer fluoroquinolones provide better resistance, compliance, efficacy, panel says

WAIKOLOA, Hawaii — The newest fluoroquinolones will provide better resistance, compliance and efficacy in treating bacterial conjunctivitis than their predecessors, according to surgeons gathered here.

Surgeons spoke of the increasingly well publicized resistance to currently available fluoroquinolones here during the American Association for Pediatric Ophthalmology and Strabismus annual meeting.

“Resistance to ciprofloxacin, ofloxacin, levofloxacin and other drugs develops during the systematic use of the antibiotics, or inappropriate use of them for viral conditions,” David B. Granet, MD, said. “Low dosing or long-term use of the drugs with tapering will also induce mutations that can lead to resistance.”

Harold R. Katz, MD, agreed. “We need the new drugs to provide a very low incidence of resistance, but to emit a potent therapeutic concentration in the target tissue, with a rapid rate of bacterial kill and low toxicity,” he said.

Two fluoroquinolones, moxifloxacin and gatifloxacin, pending all-age regulation approval (including children under 1 month old) appear to possess these characteristics, according to these surgeons.

“These drugs are 8 to 16 times more potent than their predecessors,” Dr. Katz said.

This potency makes the drugs more effective against gram-positive infections and fluoroquinolone-resistant organisms. The added potency of these drugs will restrict the usual hourly dosing to 1 to 2 drops, 3 times a day, for a shortened course, the surgeons added.