Rationale for the use of oral fluoroquinolones as empiric treatment of nursing home infections.

Despite relatively limited clinical data in nursing home patients, studies in non-nursing home settings indicate that the systemic fluoroquinolones offer a spectrum of activity against typical gram-negative bacillary nursing home pathogens that is unavailable with other oral antimicrobials, offer excellent pharmacokinetics in the elderly, and have few adverse effects. When ofloxacin and ciprofloxacin have been compared with standard empiric intravenous or oral regimens in the hospitalized elderly in the treatment of the types of complicated urinary tract infections, pneumonia, and skin and soft-tissue infections that may be encountered in nursing homes, clinical efficacy has been at least equivalent. Although not similarly tested in nursing home settings, lomefloxacin, enoxacin, and fleroxacin have given clinical results at least comparable to control oral regimens for complicated urinary tract infection in the elderly.