Bacterial resistance and failure of clinical cure could be produced by oxidative stress in patients with diabetes or cardiovascular diseases during fluoroquinolone therapy

Fluoroquinolone agents are used widely for the treatment of infectious diseases which are a common cause of deaths around the world. The level of oxidative stress in patients taking fluoroquinolone antibiotics has not been considered a factor to reduce the clinical efficacy of this kind of drugs. Patients with diabetes and/or cardiovascular diseases present abnormal levels of oxidative stress in the blood stream. In this regards, our hypothesis supposes that patients with diabetes and/or cardiovascular disease suffering a bacterial disease could experience a therapeutic failure and bacterial resistance when treated with fluoroquinolones. The crucial mechanism could be an inefficient blood distribution of the drug via red blood cell dysfunction induced by oxidative stress that might reduce the pharmacokinetic-pharmacodinamic ratios. In this way, we review the scientific information to support our hypothesis alongside possible implications. Additionally, this work exhibits the urgent need of studies considering these conditions for quinolone agents. © 2017 Elsevier Ltd

ciprofloxacin; levofloxacin; moxifloxacin; ofloxacin; quinoline derived antiinfective agent; reactive oxygen metabolite; adenosine triphosphate; antiinfective agent; antioxidant; quinolone derivative; antibiotic resistance; antibiotic therapy; area under the curve; Article; cardiovascular disease; cause of death; cell metabolism; diabetes mellitus; drug accumulation; drug bioavailability; drug distribution; drug efficacy; drug treatment failure; enzyme activation; erythrocyte; erythrocyte membrane; human; maximum plasma concentration; membrane permeability; Michaelis Menten kinetics; minimum inhibitory concentration; non insulin dependent diabetes mellitus; oxidative stress; bacterial infection; cardiovascular disease; complication; diabetes mellitus; diabetic complication; metabolism; signal transduction; theoretical model; Adenosine Triphosphate; Anti-Bacterial Agents; Antioxidants; Area Under Curve; Bacterial Infections; Cardiovascular Diseases; Diabetes Complications; Diabetes Mellitus; Drug Resistance, Bacterial; Fluoroquinolones; Humans; Models, Theoretical; Oxidative Stress; Signal Transduction

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