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Second-, third-, and fourth-gen fluoroquinolones potency compared

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FORT LAUDERDALE, Fla. – An in vitro study compared the potency of 2^nd generation fluoroquinolones (ciprofloxacin-CIP and ofloxacin-OFX) with 3^rd generation (levofloxacin-LEV) and 4^th generation fluoroquinolones (gatifloxacin-GAT and moxifloxacin-MOX) at the Association for Research in Vision and Ophthalmology (ARVO) meeting here.

Researchers R. Mather, R.P. Kowalski and associates from the Charles T. Campbell Laboratory at the University of Pittsburgh presented their poster, “The In Vitro Potency of 2^nd, 3^rd, and 4^th Generation Fluoroquinolones for Bacterial Endophthalmitis Isolates.” This study was conducted since new generations of fluoroquinolones will be joining the arsenal of ophthalmic antibiotics.

Frozen stocks of 98 bacterial isolates from endophthalmitis cases were tested. The MICs (ug/ml) of the isolates were determined to ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin and moxifloxacin using Etests. The MICs were analyzed nonparametrically as discreet data (Epistat, Richardson, Tex.) The analysis ranked all the MICs from lowest to highest and compared the antibiotics by ANOVA analysis of the ranks (not the actual MICs) using Duncan’s multiple comparisons at p=0.05 significance. The lower the median MIC the better the potency.

According to the poster, the in vitro study suggests that the 4^th generation fluoroquinolones are more potent than the 2^nd and 3^rd generation fluoroquinolones for gram-positives, and are equally potent for gram-negatives. The 4^th generation fluoroquinolones appear to cover 2^nd and 3^rd generation fluoroquinolone resistance. In this study, moxifloxacin was generally more potent than gatifloxacin for gram-positive bacteria.

The researchers reported that clinical studies will be necessary to correlate the in vitro results. They said that the 4^th generation fluoroquinolones may represent an option, or adjunct, in surgical prophylaxis or treatment of bacterial endophthalmitis.