Systematic review: fluoroquinolones for the treatment of intra-abdominal surgical infections

Background Intra-abdominal infections result in substantial morbidity and mortality. Fluoroquinolones are among the various regimens that are used for the treatment of these infections. Aim To evaluate the available data from laboratory and clinical studies regarding the use of fluoroquinolones for the treatment of patients with intra-abdominal infections. Methods We searched for relevant laboratory and clinical studies in the PubMed and the Cochrane Library databases. Results Good pharmacokinetic and pharmacodynamic properties of fluoroquinolones in inflamed abdominal tissue are reported in several laboratory studies. In six prospective non-randomized clinical studies of patients with intra-abdominal infections, the clinical success achieved with the use of fluoroquinolones ranged from 77% to 94%. In 10 randomized-controlled trials fluoroquinolone-based regimens were compared with other commonly used (mainly beta-lactam-based) regimens. Clinical success, bacterial eradication, withdrawal because of toxicity and mortality were similar between the compared treatment arms except from two randomized-controlled trials, in which clinical success was statistically higher in the fluoroquinolone treatment arm. Conclusions Fluoroquinolones seem to be an effective and relatively safe option for the treatment of patients with intra-abdominal infections.