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Quinolones

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synthetic broad-spectrum antibiotics that could be also isolated from natural sources, for example, from bacteria Pseudonocardia in soil. 
Quinolones antibiotic medications include:
  • Nalidixic acid (Nevigramon, Neggram, Wintomylon, WIN 18,320) 
  • Ciprofloxacin (Ciloxan Ophthalmic and Cipro)
  • Levofloxacin (Levaquin and QUIXIN Ophthalmic)
  • Lomefloxacin (Maxaquin)
  • Moxifloxacin (Avelox)
  • Norfloxacin (Chibroxin Ophthalmic and Noroxin Oral)
  • Ofloxacin (Floxin and Ocuflox Ophthalmic)
  • Sparfloxacin (Zagam)
  • Trovafloxacin (Trovan)
First-generation drugs (e.g., nalidixic acid) achieve minimal serum levels and are limited to gram negative bacteria (UTIs) Second-generation quinolones (fluoroquinolones - norfloxacin, ciprofloxacin): improved Gram negative coverage with activity against S. aureus (systemic infections) have increased gram-negative and systemic activity. Third-generation drugs (e.g., levofloxacin) have expanded activity against gram-positive bacteria and atypical pathogens. Fourth-generation quinolone drugs (trovafloxacin, besifloxacin) add significant activity against anaerobes. Novel 8-chloro fluoroquinolone besifloxacin (Bestivance) is a 2-nd generation fluoroqionolone and it might be the last generation, because it might be difficult to improve upon the currently available agents. 

see how Quinolones affected others
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