Not too sure what planet you live on Doc but finding support for not using the fqs as a first line agent here in the States will prove to be an exercise in futility  Just about all of the guidelines here recommend them as first line agents  You will find pretty much the same in all those reviews you are so fond of  Got into a knock down drag out fight about this a few years ago with one of your peers  He loves the damned things and produced evidence that indeed they are recommended as first line agents for just about anything you can think of  Things might of changed since then but I highly doubt it    And from my own experience dealing with these survivors RARELY if ever did they suffer from a serious infection  I would venture to say about  or more of those on my forum did not even have ANY kind of bacterial infection to begin with  Maybe that is why they got hit so hard  Just like my case  and  hour cultures showed no bacterial growth  Given a  mg a day of levaquin for two weeks to treat a suspected bladder infection when in fact I had a kidney stone and was pissing blood from it  When the cultures came back negative he then insisted I had chronic bacterial prostatitis  Even though about nine months earlier my prostate was just fine  As well as when I changed urologists down the road    The stone was on the xray but the radiologist missed it I was on these drugs for almost two months  Started out with floxin switched to cipro and finally levaquin  Complained the WHOLE time about most of these adrs we are discussing and the urologist told me flat out they had NOTHING to do with the fluoroquinolones  Safe and effective well tolerated etc etc just like you have stated within your article  Might be the reason he blew off my concerns and crippled me for life instead of stopping the drugs  May have believed they may not help but certainly could not hurt based upon such information as you are presenting  I have met only ONE doctor who has treated me in the past twenty years that had any idea regarding these reactions  And that was because she suffered them herself  Not bitching here just explaining the current situation here in the States is all   Oh and the FDA AERS system  What a joke  They excluded ANY REPORTS prior to   So you are handicapped right from the get go  Thirty five years worth of data is missing  Anything prior to  resides on another database and the two are not linked and the second database is no longer available  Takes specialized software to even access it  Play around with it a bit and you will see what I mean  Here is the link httpwwwfdablecomaersadvanced