Respiratory fluoroquinolones in the treatment of specific and non-specific lung diseases (literature review)

DOI: https://doi.org/10.29296/25877305-2024-02-04
Issue: 
2
Year: 
2024

E. Yakovleva, Candidate of Medical Sciences; Professor E. Borodulina, MD; Associate Professor E. Eremenko, Candidate of Medical Sciences
Samara State Medical University, Ministry of Health of Russia

Fluoroquinolones, which were actively studied in the 1980s, are a completely synthetic group of antibiotics with no prototype in nature. The modern classification of fluoroquinolones includes four generations. Of greater practical interest are fluoroquinolones that act on respiratory pathogens and gram-negative bacteria. Purpose. To systematize the data accumulated to date on the importance of fluoroquinolones in the treatment of lung diseases. Material and Methods. A systematic search for publications that reviewed data on the importance of fluoroquinolones in the treatment of lung diseases was performed. Results. Fluoroquinolones are bactericidal drugs. They inhibit two vital enzymes of the microbial cell, DNA gyrase and topoisomerase-4, fluoroquinolones disrupt DNA synthesis, which leads to bacterial death. It is this property that is in demand in the search for drugs for the treatment of tuberculosis in the period of increasing drug resistance of Mycobacterium tuberculosis and the lack of new tuberculosis drugs. Simultaneously with the evidence of the effectiveness of «respiratory» fluoroquinolones in the treatment of pulmonary tuberculosis, there was a trend towards banning on their use for broad indications and limited use in the treatment of lung diseases. It is currently debated whether the widespread use of multidrug-resistant tuberculosis is related to previous treatment with fluoroquinolones in patients with lung disease without tuberculosis exclusion measures. Conclusion. Thus, fluoroquinolones are a strong and modern weapon in our hands, requiring a competent and thoughtful approach to practical use.
Keywords: 
fluoroquinolones
levofloxacin
tuberculosis
lung diseases.

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