Prescribing fluoroquinolones appropriately is fundamental to the continued efficacy of this antimicrobial class. To understand the appropriate use of these agents it is helpful to examine current bacterial resistance patterns, particularly in respiratory pathogens, especially the increasing resistance in Streptococcus pneumoniae to penicillins, cephalosporins, and other B-lactam antibiotics. A current controversy is whether these resistance patterns should influence treatment strategies. In this context, the approved indications for the 4 most frequently used oral and intravenous fluoroquinolones - ciprofloxacin (Cipro®), levofloxacin (Levaquin®), gatifloxacin (Tequin®), and moxifloxacin (Avelox®) - are reviewed, as well as the recommended treatment regimens for community-acquired pneumonia, hospital-acquired pneumonia, acute bacterial exacerbations of chronic bronchitis, urinary tract infections, and skin and soft tissue infections. The contributors to this supplement comment on these issues in the following roundtable discussion.