Skin and skin structure infections: treatment with newer generation fluoroquinolones

Philip Giordano¹, Kurt Weber¹, Gail Gesin², Jason Kubert¹

¹Department of Emergency Medicine; ²Department of Pharmacy, Orlando Regional Medical Center, Orlando, Florida, USA

Abstract: Skin and skin structure infections (SSSI) are an emerging issue in healthcare. They are responsible for increasing heathcare utilization, both in hospitalizations and intravenous antibiotic use. SSSI are caused by an evolving variety of pathogens, including Gram-positive, Gram-negative, and anaerobic bacteria. In combination with mounting resistance patterns, this diverse range of bacteria mandate empiric broad-spectrum antibiotic coverage. Historically, cephalosporins and penicillins have been the mainstay of treatment, but recent data suggest newer generation fluoroquinolones are being used with increasing frequency. In 2005, moxifloxacin joined gatifloxacin and levofloxacin as newer generation fluoroquionolones with Food and Drug Administration indications for SSSIs. Even within this group there exist subtle differences that impact optimal management. This paper offers the clinician a comparative review of the antimicrobial spectrum, pharmacodynamics, pharmacokinetics, and clinical efficacy data to support the appropriate use of fluoroquinolones in SSSIs.

Keywords: Uncomplicated skin and skin structure infections, complicated skin and skin structure infections, fluoroquinolone, moxifloxacin, gatifloxacin, levofloxacin