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January 11, 1993

Quinolone Resistance: A Practical Perspective

Author Affiliations

Philadelphia, Pa

Arch Intern Med. 1993;153(1):120-121. doi:10.1001/archinte.1993.00410010140015

The recent letter by Fish et al1 discusses concern over the development of resistance to the fluoroquinolone antibiotics, especially in Staphylococcus aureus and Pseudomonas aeruginosa.2,3 They suggest that resistance to fluoroquinolones should be reexamined in comparison with rates of emergence of resistance to other classes of antibiotics. The authors cite two references4,5 that support the concepts that the incidence of resistance to the quinolones, and the development of resistance during fluoroquinolone therapy, occurs at approximately the same frequency as with β-lactam antibiotics and aminoglycosides. They conclude that quinolone resistance is not unique but is a problem common to all antibiotics. The authors acknowledge the tremendous explosion in the use of ciprofloxacin, and they concede that this usage is likely related to the reports of increasing resistance. The letter ends by suggesting that "the notoriety that the quinolones are gaining with regard to development of resistance is