Penetration into Respiratory Tissues

Fluoroquinolones produce excellent therapeutic ratios in the respiratory tract. Bronchial mucosal concentrations are 1.5 to 2 times those in serum [36-39], although ratios between sputum/bronchial secretion concentrations and those in serum after dosage within normal clinical limits range from 0.33 to 0.5 for ciprofloxacin and sparfloxacin to almost unity for pefloxacin, ofloxacin, and lomefloxacin [36]. Concentrations in alveolar lining fluid are typically two- to threefold greater than serum [37,38] and vary between the fluoroquinolones, lung parenchymal levels ranging from 4 to 10 times that in serum [36]. The highest ratios are found in alveolar macrophages [38], where concentrations 10- to 20-fold greater than serum have been found with agents such as ciprofloxacin, levoflox-acin, and temafloxacin, the recently abandoned compounds trovafloxacin, spar-floxacin, and grepafloxacin, and the newer 8-methoxyquinolones, exemplified by moxifloxacin [39].

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