Nalidixic acid
Oxolinic acid
Pipemidic acid
Piromidic acid

Narrow spectrum quinolones

Several quinolone derivatives, including cinoxacin, oxolinic acid, and pipemidic acid, were introduced into clinical use after the commercialisation of nalidixic acid in the 1960s. They are all well absorbed when taken by mouth and are in general extensively metabolized in the body before being excreted into the urine. Nalidixic acid itself is largely converted into the active metabolite hydroxynalidixic acid and the antibacterially inactive glucuronide conjugates.

Most Gram-negative bacteria, with the exception of P. aeruginosa, are susceptible to nalidixic acid and its congeners, but Gram-positive organisms are usually resistant. Susceptible bacteria readily develop resistance in the laboratory and the emergence of resistance sometimes occurs during treatment. These drugs are best suited to the treatment of cystitis, though they are also used in gastrointestinal disease. Acrosoxacin exhibits good activity against Neisseria and has been used for the treatment of gonorrhoea. The narrow spectrum  quinolones offer limited benefits and only nalidixic acid remains widely available.

This class of antibiotics includes: Acrosoxacin, Cinoxacin, Flumequine, Nalidixic acid, Oxolinic acid, Pipemidic acid, Piromidic acid.


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