Quinolones: their uses in geriatric infections.

The quinolones represent a unique class of drugs which offer a new option for clinicians to treat a wide variety of infections in the elderly patient. Whereas the emergence of resistance is a major problem with the older quinolones such as nalidixic acid, this appears to be a minor problem with the new fluoroquinolones such as norfloxacin or ciprofloxacin. These drugs are bactericidal and are well-absorbed orally. Parenteral preparations should be available in the future. The drugs are particularly active against gram-negative bacilli, including Pseudomonas aeruginosa. The fluoroquinolones are less active against pneumococci, Group A streptococci, Pseudomonas cepacia, and most anaerobes. The drugs appear potentially useful to treat urinary tract infections caused by multiply resistant pathogens, prostatitis, gastrointestinal pathogens, osteomyelitis, gram-negative pneumonia, and sexually transmitted diseases. Adverse effects occur in approximately 10% of patients and include gastrointestinal symptoms and potential central nervous system toxicity in patients receiving theophylline, non-steroidal drugs, or caffeine. The oral quinolones may reduce the costs of treating serious infections in the elderly.