Fluoroquinolone Utilization in the Emergency Departments of Academic Medical Centers

Abstract

FLUOROQUINOLONE (FQ) antibacterials are important components of the modern antimicrobial armamentarium. Their high potency, broad spectrum of activity, relative tolerability, and availability in both oral and parenteral formulations make FQs extremely useful in many clinical settings.¹ Although the potential for development of resistance to FQs was initially predicted to be very low,² recent years have witnessed increased resistance to these agents. Resistance was initially described in organisms such as Pseudomonas aeruginosa and Staphylococcus aureus,^3,4 which have borderline baseline minimum inhibitory concentrations. The increasing scope and importance of FQ resistance is evident in the recent emergence of resistance in such organisms as Escherichia coli, Klebsiella pneumoniae, Campylobacter species, Salmonella species, and Streptococcus pneumoniae.^5-8 If these trends continue, the utility of these agents will be greatly diminished.