acute, hospital-acquired Gram-positives...... empiric, acute exacerbations of COPD, etc. indications will come, IMO, one-by-one.
it looks to be the best of the fluoroquinolones, and I don't see the rash as a problem -- given a bit more (positive) physician experience. Peter knows it better.
one can dream..... imagine if this could be reproduced, and it wasn't a class effect (don't hold your breath).....
Clin Microbiol Infect. 2004 Mar;10(3):213-9.
Gemifloxacin inhibits cytokine secretion by lipopolysaccharide stimulated human monocytes at the post-transcriptional level.
Araujo F, Slifer T, Li S, Kuver A, Fong L, Remington J.
Palo Alto Medical Foundation, Palo Alto Stanford University Medical School, Stanford, California, USA.
The fluroquinolone gemifloxacin was examined for its capacity to modulate secretion of cytokines by human monocytes stimulated with lipopolysaccharide (LPS). Monocytes from six male and two female healthy volunteers were stimulated with LPS, exposed to gemifloxacin and the amounts of secreted IL-1alpha, IL-1beta, IL-6, IL-10 and TNF-alpha measured at 3, 6 and 24 h. The results revealed that LPS alone increased secretion of each cytokine significantly. Treatment of the LPS-stimulated monocytes with gemifloxacin resulted in a significant inhibition (p < 0.01) of secretion of each of the cytokines from monocytes of the eight volunteers. Nuclear extracts of the human monocyte cell line, THP-1, were used in the electrophoretic mobility shift assay to determine whether gemifloxacin affects nuclear factor-kappaB (NF-kappaB) activation. In addition, RNA from THP-1 cells was used in Northern blots to determine whether inhibition of secretion of IL-1beta and TNF-alpha by gemifloxacin occurred at the transcription or translation level. Whereas LPS induced a rapid increase in NF-kappaB activation, gemifloxacin alone did not. Gemifloxacin did not affect the kinetics or decrease the extent of activation. Northern blots indicated that the inhibitory activity of gemifloxacin occurred post-transcription. Thus, gemifloxacin may modulate the immune response by altering secretion of cytokines by human monocytes. Although the concentrations of gemifloxacin used were higher than those observed in the serum of human volunteers treated with the dose under clinical development, it should be taken into consideration that concentrations at tissue and intracellular levels may be considerably higher than serum concentrations.
edit: here's a post of interest from Peter.....
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