Ciprofloxacin is subject to efflux from J774 macrophages through a multidrug resistance-related protein-like transporter (J. M. Michot, F. Van Bambeke, M. P. Mingeot-Leclercq, and P. M. Tulkens, Antimicrob. Agents Chemother. 48: [2673][2674][2675][2676][2677][2678][2679][2680][2681][2682] 2004). Here, we compare ciprofloxacin to levofloxacin, garenoxacin, and moxifloxacin for transport. At 4 mg/liter, an apparent steady state in accumulation was reached after 30 to 60 min for all quinolones but to quite different levels (approximately 3, 5, 10, and 16 fold). Accumulation of ciprofloxacin was increased (to about 16 to 20 fold) by ATP depletion, increase in extracellular concentration, and the addition of probenecid, gemfibrozil, or MK571 (but not verapamil or GF120918). These treatments did not affect the accumulation of moxifloxacin. Levofloxacin and garenoxacin showed an intermediate behavior. Efflux of ciprofloxacin was slowed down by probenecid (half-life, 7.2 versus 1.6 min). Moxifloxacin efflux was faster and unaffected by probenecid (half-lifes, 0.27 versus 0.33 min). Efflux of levofloxacin and garenoxacin was modestly decreased by probenecid (1.5 and 2.1 fold). Accumulation of 14 C-labeled ciprofloxacin was increased by unlabeled ciprofloxacin and moxifloxacin, but moxifloxacin was two times less potent. Accumulation of moxifloxacin at 4°C was almost identical to that at 37°C, whereas that of ciprofloxacin was minimal (levofloxacin and garenoxacin showed intermediate behaviors). Cells subjected to thermal shock (56°C; 10 min) accumulated all quinolones at a similar level (16 to 23 fold). We conclude that moxifloxacin is apparently not subject to efflux from J774 macrophages, even though it can interact with the ciprofloxacin transporter. Levofloxacin and garenoxacin are partially effluxed. Data suggest that efflux plays an important role in the differential accumulation of quinolones by J774 macrophages.Fluoroquinolones have long been known to accumulate in phagocytic cells (8), but quite significant differences among closely related derivatives have been observed (3, 7, 13) which have so far not received satisfactory explanation. One factor that can modulate antibiotic accumulation in eucaryotic cells is their differential recognition by active efflux transporters (see reference 28 and the references cited therein). Fluoroquinolones are recognized by several eucaryotic multidrug transporters, most notably by two main members of the ATP-binding cassette superfamily, namely the multidrug resistance-related proteins (MRP) and the P-glycoprotein (28). In J774 macrophages, norfloxacin has been shown to be subject to efflux by a probenecid-and gemfibrozil-inhibitable transporter (2), which has been tentatively identified as a member of the MRP family (16). In this context, we have now examined the accumulation and efflux of levofloxacin and moxifloxacin in J774 macrophages in comparison with ciprofloxacin. These quinolones were chosen on the basis of their increasingly lipophilic character and potential clinic...