Dalhoff A
Institute for Infection Medicine, University Medical Center Schleswig-Holstein, Brunswiker Str. 4, 24105, Kiel, Germany,
Eur J Clin Microbiol Infect Dis. 2015 Apr;34(4):661-8. doi: 10.1007/s10096-014-2296-3. Epub 2014 Dec 17.
This review summarizes evidence that commercially available fluoroquinolones used for the treatment of bacterial infections are active against other non-bacterial infectious agents as well. Any of these fluoroquinolones exerts, in parallel to its antibacterial action, antiviral, antifungal, and antiparasitic actions at clinically achievable concentrations. This broad range of anti-infective activities is due to one common mode of action, i.e., the inhibition of type II topoisomerases or inhibition of viral helicases, thus maintaining the selective toxicity of fluoroquinolones inhibiting microbial topoisomerases at low concentrations but mammalian topoisomerases at much higher concentrations. Evidence suggests that standard doses of the fluoroquinolones studied are clinically effective against viral and parasitic infections, whereas higher doses administered topically were active against Candida spp. causing ophthalmological infections. Well-designed clinical studies should be performed to substantiate these findings.
本综述总结了证据表明，用于治疗细菌感染的市售氟喹诺酮类药物对其他非细菌性感染因子也具有活性。这些氟喹诺酮类药物中的任何一种在临床可达到的浓度下，除了具有抗菌作用外，还具有抗病毒、抗真菌和抗寄生虫作用。这种广泛的抗感染活性归因于一种共同的作用模式，即抑制II型拓扑异构酶或抑制病毒解旋酶，从而保持氟喹诺酮类药物在低浓度下抑制微生物拓扑异构酶但在高得多的浓度下抑制哺乳动物拓扑异构酶的选择性毒性。有证据表明，所研究的氟喹诺酮类药物的标准剂量在临床上对病毒和寄生虫感染有效，而局部给予的较高剂量对引起眼部感染的念珠菌属有活性。应进行精心设计的临床研究以证实这些发现。
