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Quinolones in the treatment of lower respiratory tract infections caused by intracellular pathogens

Chinolone in der Behandlung tiefer Atemwegsinfektionen durch intrazelluläre Erreger

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Summary

Intracellular pathogens are inhibited to varying degrees, depending upon the strain of the organism and the quinolone tested. Quinolones achieve levels in the lower respiratory tract that equal or exceed serum concentrations, and they also achieve good intracellular concentrations. Experimental models of intracellular infection have demonstrated the efficacy of ciprofloxacin, difloxacin, fleroxacin, ofloxacin and pefloxacin. Animal models of experimental legionellosis have confirmedin vivo their efficacy in this field. Thus, quinolones appear to be a safe and efficacious alternative treatment in lower respiratory tract infection (LRTI) due to intracellular pathogens. Considering thein vitro and experimental studies, quinolones should play an important role in the treatment of LRTI caused by intracellular pathogens, and prospective controlled studies are strongly recommended.

Zusammenfassung

Chinolone haben je nach Art des Erregers und Art der Substanz unterschiedlich starke Hemmwirkung gegen intrazelluläre Mikroben. Wirkstoffspiegel in den tiefen Atemwegen liegen mindestens im Bereich der Serumspiegel, Chinolone erreichen außerdem brauchbare intrazelluläre Konzentrationen. In experimentellen Modellen zu intrazellulären Infektionen haben sich Ciprofloxacin, Difloxacin, Fleroxacin, Ofloxacin und Pefloxacin als wirksam erwiesen. Auch bei Tiermodellen zur Legionellose wurde die Aktivität der Chinolonein vivo belegt. Es ist folglich anzunehmen, daß Chinolone bei tiefen Atemwegsinfektionen durch intrazelluläre Erreger eine sichere und wirksame therapeutische Alternative darstellen. Aus denIn-vitro-Daten und experimentellen Studien gewonnene Erkenntnisse zur Bedeutung der Chinolone als Therapeutika tiefer Atemwegsinfektionen durch intrazelluläre Erreger sollten nun in prospektiven, kontrollierten Studien auf ihre Gültigkeit für die Klinik geprüft werden.

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  1. Department of Infectious Diseases, University of Lille II, Central Hospital, F-59208, Tourcoing, France

    C. Chidiac M.D. & Y. Mouton M.D.

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Chidiac, C., Mouton, Y. Quinolones in the treatment of lower respiratory tract infections caused by intracellular pathogens. Infection 19 (Suppl 7), S365–S371 (1991). https://doi.org/10.1007/BF01715829

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