Dual activity of fluoroquinolones against Streptococcus pneumoniae: the facts behind the claims

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Abstract
Recently, there have been several reports of the dual activity of some fluoroquinolones used to treat infections probably caused by Streptococcus pneumoniae.1–3 Furthermore, there have been numerous declarations as to the clinical advantages of using dual-activity agents, including minimizing the development of resistance. These reports have been inconsistent, with fluoroquinolones being reported as having dual activity in some reports but not in others, and thus remain controversial.1,3–7 In order to clarify the reasons behind the inconsistencies, we have summarized the flaws of the methods by which the current data on the dual activity of fluoroquinolones against S. pneumoniae have been collected, and the conclusions that have been drawn. We offer suggestions of methods that may be used to clarify these reports of dual activity in the future, as well as a critical analysis of whether any truly dual-activity fluoroquinolones have yet been created.

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