ARTICLE Antimicrobial activity of prulifloxacin in comparison with other fluoroquinolones against community-acquired urinary and respiratory pathogens isolated in Greece D. E. Karageorgopoulos & S. Maraki & A. C. Vatopoulos & G. Samonis & G. C. Schito & M. E. Falagas Received: 28 December 2012 / Accepted: 29 April 2013 / Published online: 19 May 2013 # Springer-Verlag Berlin Heidelberg 2013 Abstract Prulifloxacin, the prodrug of ulifloxacin, is a broad- spectrum fluoroquinolone rather recently introduced in certain European countries. We compared the antimicrobial potency of ulifloxacin with that of other fluoroquinolones against common urinary and respiratory bacterial pathogens. The microbial isolates were prospectively collected between Jan- uary 2007 and May 2008 from patients with community- acquired infections in Greece. Minimum inhibitory concen- trations (MICs) were determined for ciprofloxacin, levofloxacin, moxifloxacin (for respiratory isolates only), and ulifloxacin using the E-test method. The binary loga- rithms of the MICs [log 2 (MICs)] were compared by using the Wilcoxon signed-ranks test. A total of 409 isolates were studied. Ulifloxacin had the lowest geometric mean MIC for the 161 Escherichia coli, 59 Proteus mirabilis, and 22 Staph- ylococcus saprophyticus urinary isolates, the second lowest geometric mean MIC for the 38 Streptococcus pyogenes re- spiratory isolates (after moxifloxacin), and the third lowest geometric mean MIC for the 114 Haemophilus influenzae and the 15 Moraxella catarrhalis respiratory isolates (after cipro- floxacin and moxifloxacin). Compared with levofloxacin, ulifloxacin had lower log 2 (MICs) against E. coli (p <0.001), P. mirabilis (p <0.001), S. saprophyticus (p <0.001), and S. pyogenes ( p <0.001). Compared with ciprofloxacin, ulifloxacin had lower log 2 (MICs) against P. mirabilis (p <0.001), S. saprophyticus (p =0.008), and S. pyogenes (p <0.001), but higher log 2 (MICs) against H. influenzae (p <0.001) and M. catarrhalis (p =0.001). In comparison with other clinically relevant fluoroquinolones, ulifloxacin had the most potent antimicrobial activity against the community-acquired urinary isolates studied and very good activity against the respiratory isolates. Introduction The quinolones represent one of the few synthetic classes of antimicrobial agents. Nalidixic acid, the first member of this class, is primarily active against Gram-negative pathogens, but members of subsequent fluoroquinolone generations show improved activity against Gram-positive cocci [1, 2]. Over the years, several analogs of the fluoroquinolone class of antibiotics have entered into different stages of clinical development. Relatively few, however, have made an im- portant difference in terms of a broader spectrum of antimi- crobial activity or of a better safety and clinical effectiveness D. E. Karageorgopoulos : M. E. Falagas (*) Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 15123 Marousi, Athens, Greece e-mail: m.falagas@aibs.gr S. Maraki Department of Clinical Bacteriology, University Hospital of Heraklion, Heraklion, Crete, Greece A. C. Vatopoulos Department of Microbiology, National School of Public Health, Athens, Greece A. C. Vatopoulos Iatropolis Diagnostic Center, Halandri, Athens, Greece G. Samonis Department of Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece G. C. Schito Institute of Microbiology, University of Genoa, Genoa, Italy M. E. Falagas Department of Internal Medicine—Infectious Diseases, Mitera Hospital, Hygeia Group, Athens, Greece M. E. Falagas Department of Medicine, Tufts University School of Medicine, Boston, MA, USA Eur J Clin Microbiol Infect Dis (2013) 32:1417–1422 DOI 10.1007/s10096-013-1891-z