The first generation of fluoroquinolones such as ciprofloxacin and ofloxacin are inactive against most anaerobic bacteria. However, some broad-spectrum quinolones, which have recently become clinically available or are under active development, have significant antianaerobic activity (85). Quinolones with low activity against anaerobes include ciproflox-acin, ofloxacin, levofloxacin, fleroxacin, pefloxacin, enoxacin, and lomefloxacin. Compounds with intermediate antianaerobic activity include sparfloxacin and grepafloxacin. Trovafloxacin, gatifloxacin, and moxifloxacin yield low MICs against most groups of anaerobes. Moxifloxacin was recently approved by the FDA for the treatment of complicated intra-abdominal infections in adults. Quinolones with the greatest in vitro activity against anaerobes include clinafloxacin and sitafloxacin (86). However, the use of the quinolones is restricted in growing children because of their possible adverse effects on the cartilage.

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