Bacterial Infections in the Elderly Patient: Focus on Sitafloxacin

Abstract

Sitafloxacin (DU-6859a) is a new-generation oral fluoroquinolone with in vitro activity against a broad range of Gram-positive and -negative bacteria, including anaerobic bacteria, as well as against atypical bacterial pathogens. Particularly in Japan this antibiotic was approved in 2008 for treatment of a number of bacterial infections caused by Gram-positive cocci and Gram-negative cocci and rods, including anaerobia atypical bacterial pathogens. As compared to oral levofloxacin sitafloxacin was non-inferior in the treatment of community-acquired pneumonia and non-inferior in the treatment of complicated urinary tract infections, according to the results of randomized, double-blind, multicentre, non-inferiority trials. Non-comparative studies demonstrated the efficacy of oral sitafloxacin in otorhinolaryngological infections, urethritis in men, cervicitis in women and odontogenic infections. Most common adverse reactions were gastrointestinal disorders and laboratory abnormalities in patients receiving oral sitafloxacin; diarrhea and liver enzyme elevations were among the common. In the Japanese population sitafloxacin covers broad spectrum of bacteria as compared to carbapenems, whereas in the Caucasians its use is currently limited due to the potential for ultraviolet A phototoxicity. Sitafloxacin is a promising therapeutic agent which merits further investigation in randomized clinical trials of elderly patients.

A study of the status of the elderly; bacterial infections, their causes, prevention, and control methods

“…Poor function of body systems such as lack of motor function, urinary and fecal incontinence, dysphagia, disruption in blood flow, or delayed wound healing or all of these cases in combination can increase susceptibility to infection. This may be the cause of the elderly having the highest rank among patients with nosocomial infection (8,18,19,(24)(25)(26). Factors related to lifestyle: Of the factors related to lifestyle which increase susceptibility to infection, the retirement period, desire to travel and visit relatives or different places, and exposure to contaminants can be noted.…”

Structural Characterization of the Millennial Antibacterial (Fluoro)Quinolones—Shaping the Fifth Generation

“…Thus, clinafloxacin (with a C8 chlorine atom) was associated with severe side effects (phototoxicity hypoglycaemia) [ 18 ]. Sitafloxacin, a FQN approved in Japan (2008) and Thailand (2012) contains in the C7 position a pyrrolidinyl fragment included in a spiro substituent, [(7S)-7-amino-5-azaspiro[2.4]heptanyl] [ 57 , 177 ]. This FQN produces mild to moderate adverse reactions (mostly gastrointestinal disorders and laboratory abnormalities, phototoxicity potential) [ 178 , 179 ].…”