Vol.53 No.2 February 2005

A study on the effectiveness of a new fluoroquinolone antimicrobial, gatifloxacin, for acute bacterial sinusitis

Rinya Sugita

Sugita ENT Clinic, 3-14-1 Takasu, Mihama-ku, Chiba, Japan

Abstract

The efficacy of gatifloxacin (GFLX) in acute bacterial sinusitis was examined based on drug sensitivity, clinical efficacy, safety, and tissue penetration. Prior to administration of GFLX, specimens were collected and the antibacterial activities of GFLX against 17 clinical strains of Streptococcus pneumoniae that were isolated from these specimens were inspected. Gatifloxacin was found to have a minimum inhibitory concentration (MIC₉₀) of 0.5 μg/mL, indicating that GFLX has greater antimicrobial activity as compared to levofloxacin (LVFX), clavulanic acid/amoxicillin (CVA/AMPC), and cefcapene (CFPN), which have an MIC₉₀ of 1 μg/mL. Fluoroquinolone antimicrobials -GFLX and LVFX- with an MIC₉₀: ≤0.06 μg/mL, demonstrated the greatest bactericidal activity against 10 strains of Haemophilus influenzae. These fluoroquinolone antibiotics were also found to be the most active against 11 strains of Moraxella catarrhalis (MIC₉₀: ≤0.06 μg/mL). An examination of the clinical efficacy revealed that GFLX was very effective with an actual efficiency of 21.6% and a significant efficacy of 86.3%. In addition, the safety of GFLX was established because none of the cases developed hypoglycemia and no serious adverse drug reactions were observed. The concentration of GFLX in nasal discharge was measured 1 to 12 h after GFLX was administered. The concentration ranged from 0.69 to 7.04 μg/g, indicating that GFLX had migrated into the pus at a concentration that was well over the MIC₉₀ of the S. pneumoniae, H. influenzae, and M. catarrhalis isolates. Thus, GFLX has good tissue penetration ability. Our results suggest that GFLX is clinically very effective in treating acute bacterial sinusitis.

Key word

gatifloxacin, acute bacterial sinusitis, nasal penetration

Received

October 25, 2004

Accepted

January 5, 2005

Jpn. J. Chemother. 53 (2): 134-141, 2005