"Which role for the quinolones in the treatment of upper respiratory infections?"

Taking into consideration their broad bactericial activity and the high penetration into soft tissues of upper respiratory tract and their relevant secretion, the new quinolones can now be used also in ear, nose and throat disease. Good results have been obtained with ciprofloxacin, ofloxacin and enoxacin in patients with acute purulent otitis or exacerbation of chronic otitis. Ciprofloxacin resulted successful in the treatment of malignant otitis externa with the double advantage of a less expensive treatment and a low incidence of side effects in comparison with the conventional parenteral antibiotics. Satisfactory outcomes have been reported also in the treatment of tonsillitis and sinusitis. Promising results derived from a recent pilot study, in which the efficacy and safety of rufloxacin was assessed in the treatment of acute rhinosinusitis or acute in chronic rhinosinusitis. In view of its long half-life, the drug was given for 5 days, with a single 400 mg loading dose followed by maintenance doses of 200 mg/day. The following clinical parameters were evaluated before, during and at the end of the therapy: spontaneous and provoked pain, nasal stuffiness and secretion, fever, opacity as revealed by transillumination of involved paranasal sinuses. The marked improvement of the symptomatology after the treatment let us conclude that the newer quinolones constitute a valide alternative to conventional agents in the treatment of upper respiratory tract infections.