Fluoroquinolones in chronic obstructive pulmonary disease

BMJ 1994;308:1437 (28 May)

Letters

Fluoroquinolones in chronic obstructive pulmonary disease

EDITOR, - In their editorial Harold Hosker and colleagues suggestthat fluoroquinolones are suitable second line antibiotics forinfective exacerbations of chronic obstructive pulmonary disease.¹We report two cases that illustrate our reservations about thissuggestion.

Case 1 - A 75 year old woman was admitted complaining of severeshortness of breath and right sided pleuritic chest pain. Shehad been admitted several times before with exacerbation ofchronic obstructive pulmonary disease. Before this admissionshe had taken ciprofloxacin 500 mg twice daily and prednisolonefor six days. On examination she had signs of right lower lobepneumonia, which was confirmed on chest radiography. She washypoxic (oxygen pressure 6.8 kPa, carbon dioxide pressure 5.21kPa) and had a white cell count of 23x10⁹/1, with 84% neutrophils.Streptococcus pneumoniae capsular type 4 was isolated from bloodcultures, with a minimum inhibitory concentration for ciprofloxacinof 4 mg/l and for . . . [Full text of this article]