To the Editor. —
Review of recent medical literature reveals a large number of publications concerning the development of resistance to the fluoroquinolone antibiotics. Various studies have demonstrated resistance rates ranging as high as 40% to 80% for Staphylococcus aureus and Pseudomonas aeruginosa.1,2 Resistance has also been reported for a multitude of other organisms, including most species of Enterobacteriaceae as well as other gram-positive organisms.1While resistance to the fluoroquinolones is admittedly a cause for concern, we feel that this issue needs to be examined from the perspective of how the quinolones compare with other antimicrobial agents. In reviewing the development of resistance during therapy, Milatovic and Braveny have shown the quinolones to be comparable to β-lactams, aminoglycosides, and imipenem in terms of resistance and clinical failure rates.3 A second study4 of comparative antimicrobial resistance among 14 European countries also demonstrated that other classes of antibiotics, such
Fish DN, Piscitelli SC, Danziger LH. Quinolone Resistance: An Alternative Perspective. Arch Intern Med. 1992;152(6):1329–1330. doi:10.1001/archinte.1992.00400180165032
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