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Gemifloxacin use in the treatment of acute bacterial exacerbation of chronic bronchitis

Authors Jivcu C, Gotfried M

Published 31 July 2009 Volume 2009:4 Pages 291—300


Review by Single-blind

Peer reviewer comments 2

Cristian Jivcu1, Mark Gotfried2

1Department of Internal Medicine, Banner Good Samaritan Medical Center, Phoenix, AZ, USA; 2Department of Medicine, University of Arizona, Phoenix, AZ, USA

Abstract: The newest generation of fluoroquinolones have proven efficacy against bacterial organisms associated with acute exacerbation of chronic bronchitis (AECB). Gemifloxacin, as one of the quinolones in this class, exhibits many of the pharmacokinetic and pharmacodynamic characteristics of the class with a few notable differences. Against Streptococccus pneumoniae it has a lower minimal inhibitory concentration (MIC) than the other respiratory fluoroquinolones and it has activity against both bacterial DNA gyrase and topoisomerase IV. The increased activity of gemifloxacin against both enzymes may be associated with decreased rates of resistance. Clinically, gemifloxacin has been shown to have positive effects on length of hospitalization and increased success at long-term follow-up in AECB patients. These associations were observed in noninferiority comparison studies. Although an advantage with the use of gemifloxacin in AECB is suggested, there are no comparison data is available to conclude that gemifloxacin is superior to the other respiratory fluoroquinolones. Gemifloxacin is generally well tolerated, but is associated with a characteristic rash and gastrointestinal upset as its most common observed side effects.

Keywords: gemifloxacin, respiratory fluoroquinolones, acute exacerbation of chronic bronchitis

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