Review of third-and fourth-generation fluoroquinolones in ophthalmology: in-vitro and in-vivo efficacy.

@article{Scoper2008ReviewOT,
  title={Review of third-and fourth-generation fluoroquinolones in ophthalmology: in-vitro and in-vivo efficacy.},
  author={Stephen V Scoper},
  journal={Advances in therapy},
  year={2008},
  volume={25 10},
  pages={979-94}
}
INTRODUCTION Beginning with second-generation ciprofloxacin 0.3% and ofloxacin 0.3%, fluoroquinolones have been widely used in the treatment and prophylaxis of ocular infections. However, their in-vitro potencies have been decreasing steadily since their introduction. Third-generation levofloxacin 0.5% produces higher ocular tissue penetration, thereby reducing the risk of selecting for decreased fluoroquinolone potency. Fourth-generation gatifloxacin 0.3% and moxifloxacin 0.5% have structural… CONTINUE READING

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Beginning with second - generation ciprofloxacin 0.3% and ofloxacin 0.3% , fluoroquinolones have been widely used in the treatment and prophylaxis of ocular infections .
Beginning with second - generation ciprofloxacin 0.3% and ofloxacin 0.3% , fluoroquinolones have been widely used in the treatment and prophylaxis of ocular infections .
Beginning with second - generation ciprofloxacin 0.3% and ofloxacin 0.3% , fluoroquinolones have been widely used in the treatment and prophylaxis of ocular infections .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
Beginning with second - generation ciprofloxacin 0.3% and ofloxacin 0.3% , fluoroquinolones have been widely used in the treatment and prophylaxis of ocular infections .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
A new third - generation formulation , levofloxacin 1.5% , was recently introduced , demonstrating increased ocular penetration compared with gatifloxacin 0.3% but clinical equivalence to its second - generation parent , ofloxacin 0.3% , in two randomized trials .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
Fourth - generation gatifloxacin 0.3% and moxifloxacin 0.5% have structural modifications that both reduce risk of resistance and improve potency against Gram - positive bacteria .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
The five in - vitro studies demonstrated that moxifloxacin and gatifloxacin are statistically more potent than levofloxacin against Gram - positive organisms and similar in potency in most cases of Gram - negative bacteria .
A MEDLINE search was conducted using the following search terms : moxifloxacin or gatifloxacin ; levofloxacin ; minimum inhibitory concentration or prevention or prophylaxis ; keratitis or endophthalmitis .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
Fourth - generation gatifloxacin 0.3% and moxifloxacin 0.5% have structural modifications that both reduce risk of resistance and improve potency against Gram - positive bacteria .
In - vivo animal models testing moxifloxacin or gatifloxacin against levofloxacin 0.5% ( no clinical trials testing the efficacy of levofloxacin 1.5% have yet been published ) demonstrated that fourth - generation agents were superior to third - generation levofloxacin 0.5% for prophylaxis of Gram - positive bacteria - induced infections and were equal to , or better than , levofloxacin 0.5% for the treatment of Gram - negative infections . CONCLUSION .
Although levofloxacin 1.5% has demonstrated superior ocular penetration relative to gatifloxacin , the limited available data do not suggest this translates into superior clinical activity compared with moxifloxacin , which has significantly greater ocular penetration and better Gram - positive potency than gatifloxacin .
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