Fluoroquinolone resistance: challenges for disease control: challenges for disease control

The fluoroquinolones are an effective and widely used group of antimicrobials in community-and healthcare-associated infections, including those caused by Salmonella enterica, Campylobacter spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Neisseria gonorrhoeae and Streptococcus pneumoniae. Decreased susceptibility and full resistance to fluoroquinolones has emerged in each of these pathogens, causing treatment failures. The widespread use of fluoroquinolones in humans and in animal husbandry has been an important driver of resistance. Clonal spread, in hospitals and the community, aided by the international movement of humans and transport of food, has led to the worldwide dissemination of resistant strains. A reassessment of fluoroquinolone breakpoints to detect first-step resistant mechanisms, attention to dose regimens and adherence to appropriate use in humans and in animal husbandry is essential if this valuable group of antimicrobials are to remain useful.