Lipsky B A, Baker C A
Veterans Affairs Puget Sound Health Care System and University of Washington School of Medicine, Seattle 98108-1532, USA.
Clin Infect Dis. 1999 Feb;28(2):352-64. doi: 10.1086/515104.
For 2 decades fluoroquinolones have been found to be generally well-tolerated and safe. Adverse events may be inherent to the class or influenced by structural modifications. The commonest adverse events are gastrointestinal tract (GI) and central nervous system (CNS) reactions; nephrotoxicity and tendinitis are infrequent, but agents differ greatly in phototoxic potential. Fluoroquinolones are safe in elderly, human immunodeficiency virus-infected, and neutropenic patients, but because of possible effects on articular cartilage, they are not currently recommended for children or pregnant women. Four new agents have recently been licensed. Levofloxacin causes few GI or CNS adverse events and is minimally phototoxic. Sparfloxacin infrequently causes GI or CNS effects but is associated with relatively high rates of phototoxicity and prolongation of the electrocardiographic QTc interval (Q-T interval, corrected for heart rate). Grepafloxacin causes relatively high rates of GI effects, taste perversion, and QTc interval prolongation, but it is minimally phototoxic. Trovafloxacin is associated with a moderate rate of GI effects and a relatively high incidence of dizziness but has low phototoxic potential.
二十年来，人们发现氟喹诺酮类药物总体耐受性良好且安全。不良事件可能是该类药物所固有的，也可能受结构修饰的影响。最常见的不良事件是胃肠道（GI）和中枢神经系统（CNS）反应；肾毒性和肌腱炎并不常见，但不同药物的光毒性潜力差异很大。氟喹诺酮类药物在老年人、感染人类免疫缺陷病毒的患者和中性粒细胞减少的患者中是安全的，但由于可能对关节软骨产生影响，目前不建议用于儿童或孕妇。最近有四种新药获得许可。左氧氟沙星引起的胃肠道或中枢神经系统不良事件较少，且光毒性极小。司帕沙星很少引起胃肠道或中枢神经系统效应，但与相对较高的光毒性发生率和心电图QTc间期（Q-T间期，校正心率）延长有关。格帕沙星引起胃肠道效应、味觉异常和QTc间期延长的发生率相对较高，但光毒性极小。曲伐沙星与中等程度的胃肠道效应发生率和相对较高的头晕发生率相关，但光毒性潜力较低。
