Antiviral, antifungal, and antiparasitic activities of fluoroquinolones optimized for treatment of bacterial infections: a puzzling paradox or a logical consequence of their mode of action?

Eur J Clin Microbiol Infect Dis. 2015 Apr;34(4):661-8. doi: 10.1007/s10096-014-2296-3. Epub 2014 Dec 17.

Abstract

This review summarizes evidence that commercially available fluoroquinolones used for the treatment of bacterial infections are active against other non-bacterial infectious agents as well. Any of these fluoroquinolones exerts, in parallel to its antibacterial action, antiviral, antifungal, and antiparasitic actions at clinically achievable concentrations. This broad range of anti-infective activities is due to one common mode of action, i.e., the inhibition of type II topoisomerases or inhibition of viral helicases, thus maintaining the selective toxicity of fluoroquinolones inhibiting microbial topoisomerases at low concentrations but mammalian topoisomerases at much higher concentrations. Evidence suggests that standard doses of the fluoroquinolones studied are clinically effective against viral and parasitic infections, whereas higher doses administered topically were active against Candida spp. causing ophthalmological infections. Well-designed clinical studies should be performed to substantiate these findings.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use
  • Antiparasitic Agents / pharmacology*
  • Antiparasitic Agents / therapeutic use
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • Clinical Trials as Topic
  • DNA Helicases / antagonists & inhibitors
  • DNA Topoisomerases, Type I / metabolism
  • Drug Repositioning
  • Fluoroquinolones / pharmacology*
  • Fluoroquinolones / therapeutic use
  • Humans

Substances

  • Anti-Bacterial Agents
  • Antifungal Agents
  • Antiparasitic Agents
  • Antiviral Agents
  • Fluoroquinolones
  • DNA Helicases
  • DNA Topoisomerases, Type I