Geremia Nicholas, Giovagnorio Federico, Colpani Agnese, De Vito Andrea, Botan Alexandru, Stroffolini Giacomo, Toc Dan-Alexandru, Zerbato Verena, Principe Luigi, Madeddu Giordano, Luzzati Roberto, Parisi Saverio Giuseppe, Di Bella Stefano
Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale "dell'Angelo", 30174 Venice, Italy.
Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile "S.S. Giovanni e Paolo", 30122 Venice, Italy.
Pharmaceuticals (Basel). 2024 Dec 11;17(12):1673. doi: 10.3390/ph17121673.
: Biofilm-associated infections frequently span multiple body sites and represent a significant clinical challenge, often requiring a multidisciplinary approach involving surgery and antimicrobial therapy. These infections are commonly healthcare-associated and frequently related to internal or external medical devices. The formation of biofilms complicates treatment, as they create environments that are difficult for most antimicrobial agents to penetrate. Fluoroquinolones play a critical role in the eradication of biofilm-related infections. Numerous studies have investigated the synergistic potential of combining fluoroquinolones with other chemical agents to augment their efficacy while minimizing potential toxicity. Comparative research suggests that the antibiofilm activity of fluoroquinolones is superior to that of beta-lactams and glycopeptides. However, their activity remains less effective than that of minocycline and fosfomycin. Noteworthy combinations include fluoroquinolones with fosfomycin and aminoglycosides for enhanced activity against Gram-negative organisms and fluoroquinolones with minocycline and rifampin for more effective treatment of Gram-positive infections. Despite the limitations of fluoroquinolones due to the intrinsic characteristics of this antibiotic, they remain fundamental in this setting thanks to their bioavailability and synergisms with other drugs. : A comprehensive literature search was conducted using online databases (PubMed/MEDLINE/Google Scholar) and books written by experts in microbiology and infectious diseases to identify relevant studies on fluoroquinolones and biofilm. : This review critically assesses the role of fluoroquinolones in managing biofilm-associated infections in various clinical settings while also exploring the potential benefits of combination therapy with these antibiotics. : The literature predominantly consists of in vitro studies, with limited in vivo investigations. Although real world data are scarce, they are in accordance with fluoroquinolones' effectiveness in managing early biofilm-associated infections. Also, future perspectives of newer treatment options to be placed alongside fluoroquinolones are discussed. This review underscores the role of fluoroquinolones in the setting of biofilm-associated infections, providing a comprehensive guide for physicians regarding the best use of this class of antibiotics while highlighting the existing critical issues.
生物膜相关感染常常累及多个身体部位，是一项重大的临床挑战，通常需要采取包括手术和抗菌治疗在内的多学科方法。这些感染通常与医疗保健相关，且常常与体内或体外医疗设备有关。生物膜的形成使治疗变得复杂，因为它们创造了大多数抗菌药物难以穿透的环境。氟喹诺酮类药物在根除生物膜相关感染中起着关键作用。众多研究探讨了将氟喹诺酮类药物与其他化学药物联合使用的协同潜力，以提高其疗效，同时将潜在毒性降至最低。比较研究表明，氟喹诺酮类药物的抗生物膜活性优于β-内酰胺类和糖肽类。然而，它们的活性仍低于米诺环素和磷霉素。值得注意的联合用药包括氟喹诺酮类与磷霉素和氨基糖苷类联合，以增强对革兰氏阴性菌的活性，以及氟喹诺酮类与米诺环素和利福平联合，以更有效地治疗革兰氏阳性菌感染。尽管由于这类抗生素的固有特性，氟喹诺酮类药物存在局限性，但由于其生物利用度以及与其他药物的协同作用，它们在这种情况下仍然至关重要。：通过在线数据库（PubMed/MEDLINE/谷歌学术）以及微生物学和传染病领域专家撰写的书籍进行了全面的文献检索，以确定关于氟喹诺酮类药物和生物膜的相关研究。：本综述批判性地评估了氟喹诺酮类药物在各种临床环境中管理生物膜相关感染的作用，同时还探讨了这些抗生素联合治疗的潜在益处。：文献主要由体外研究组成，体内研究有限。尽管真实世界的数据稀缺，但它们与氟喹诺酮类药物在管理早期生物膜相关感染方面的有效性一致。此外，还讨论了与氟喹诺酮类药物一起使用的新治疗选择的未来前景。本综述强调了氟喹诺酮类药物在生物膜相关感染中的作用，为医生提供了关于这类抗生素最佳使用方法的全面指南，同时突出了现有的关键问题。
