Tag Archives: quinolones

Ciprofloxacin and other fluoroquinolones: should you think twice about prescribing?

Fluoroquinolones (ciprofloxacin, moxifloxacin and norfloxacin) (FQ) are essential agents for directed treatment of certain types of resistant aerobic Gram negative bacterial species where FQ susceptibility  has been proven.  They are best avoided as empirical  therapy or where there is an alternative due to these potential serious side effects:

Sparing meropenem 101 – treatment of ESCPM species and AmpC betalactamases unpacked

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane Infectious disease and microbiology trainees diligently learn about organisms that have a type of broad-spectrum beta-lactamase (i.e. an enzyme that can inactivate betalactam antibiotics) called ‘AmpC’.  These enzymes are encoded by a gene that is usually located on the chromosome of many Gram-negative […]

Antimicrobial prophylaxis, quinolone resistance and prostate biopsy safety

Guest post: Patrick Harris, Staff Specialist in Microbiology, Central Laboratory, Pathology Queensland, Brisbane Overseas travel and prostate biopsies: a key risk-factor for infectious complications with multi-drug resistant bacteria Given an ageing population and the current reliance upon PSA testing to screen for prostate cancer, patients are increasingly being referred for trans-rectal ultrasound (TRUS)-guided prostate biopsies.  Millions […]

Antibiotics and the QT Interval

Guest post : Ian Whyte, Professor of Clinical Pharmacology at Calvary Mater Newcastle and University of Newcastle Case report (Knorr et al 2008 Ciprofloxacin-induced Q-T interval prolongation) 16-year-old boy was admitted for the treatment of an acute flare of Crohn’s disease and a perirectal abscess. The patient was started on ciprofloxacin 400 mg IV twice daily […]

Relative mortality risk from antibiotic use compared

Much time is spent discussing the development of antimicrobial resistance and changes to the microbiome but perhaps should we should also focus on the potential for patient mortality.  Based on best current estimates, trimethoprim, macrolides and quinolones may be less safe than chloramphenicol in certain patient populations. A future posting will provide a practical approach to the […]

Reducing ESBL Gram negative fluoroquinolone resistance – what is the ecological sweet spot for usage?

This excellent recent paper from Sarma et al brings focus on what the target level of quinolone use should be in order to have an impact on quinolone resistance in Enterobacteriaceae.  It describes the situation across a region of England (9 hospitals and other facilities) where quite stringent control of cephalosporin use was already in place […]