Fluoroquinolone

Fluoroquinolone antibiotics demonstrate excellent antimicrobial effcacy in various clinical felds. Especially, levofoxacin and moxifoxacin have antimicrobial effcacy against Helicobacter pylori (H. pylori). They have been used effectively for H. pylori eradication with fewer side effects instead of bismuth quadruple therapy. Unfortunately, the recent rapid rise in resistance has made the prospect of fuoroquinolone-containing therapy unfavorable. The increase of resistance has become a signifcant limitation for providing effective eradication result. The main antimicrobial mechanism of fuoroquinolone is the interruption of DNA replication by interfering with DNA gyrase and topoisomerase IV. Resistance of fuoroquinolone antibiotics was derived from the mutation of gyrA which encodes DNA gyrase A, especially point mutation of Asn-87. However, novel fuoroquinolones show better effcacy as to overcome the resistance caused by gyrA mutation. Epidemiologic study for point mutation of resistance gene might be helpful for the development of molecular diagnostic tool and novel fuoroquinolone agent. The development of novel molecular methods for rapid determination of fuoroquinolone resistance could be the key to overcoming resistance.