Related Experiment Videos
Ciprofloxacin and Clostridium difficile-associated diarrhoea
C L Golledge1, C F Carson, G L O'Neill
1Central Microbiological Laboratories, Western General Hospital, Edinburgh UK.
Abstract:
Recent reports have implicated ciprofloxacin as a cause of Clostridium difficile-associated diarrhoea. This problem was examined in three ways. First, the MIC of ciprofloxacin for C. difficile was determined. The MIC range was 8-32 mg/L, with C. difficile were 'treated' with ciprofloxacin and clindamycin in a test-tube, and the growth of C. difficile monitored. The clindamycin-treated emulsions supported growth of C. difficile, while the ciprofloxacin-treated and control emulsions did not differ significantly and failed to support the growth of C. difficile. Finally, 213 patients on ciprofloxacin monotherapy were investigated. Twenty-nine patients were given ciprofloxacin as treatment for diarrhoea, while a further 15 patients developed diarrhoea while being treated. None of these 44 patients harboured C. difficile. Faecal samples from 73 of the remaining 169 patients who did not have or develop diarrhoea were investigated for C. difficile, but none was positive. It was concluded that ciprofloxacin is unlikely to promote C. difficile-associated diarrhoea.
Insights
Ciprofloxacin is unlikely to cause Clostridium difficile-associated diarrhea. Studies found it inhibited bacterial growth in vitro and no patients on ciprofloxacin developed this condition.
Area of Science:
- Microbiology
- Pharmacology
- Clinical Medicine
Background:
- Recent reports suggest a link between ciprofloxacin use and Clostridium difficile-associated diarrhea (CDAD).
- Understanding this potential association is crucial for patient safety and antibiotic stewardship.
Purpose of the Study:
- To investigate the potential of ciprofloxacin to promote Clostridium difficile-associated diarrhea.
- To evaluate the in vitro activity of ciprofloxacin against C. difficile.
- To assess the incidence of CDAD in patients receiving ciprofloxacin monotherapy.
Main Methods:
- Determined the minimum inhibitory concentration (MIC) of ciprofloxacin for C. difficile.
- Assessed C. difficile growth in vitro when exposed to ciprofloxacin and clindamycin.
- Conducted a clinical investigation of 213 patients on ciprofloxacin monotherapy for CDAD.
Main Results:
- The MIC of ciprofloxacin for C. difficile ranged from 8-32 mg/L.
- Ciprofloxacin inhibited C. difficile growth in vitro, unlike clindamycin.
- No cases of C. difficile infection were detected in 213 patients treated with ciprofloxacin.
Conclusions:
- Ciprofloxacin is unlikely to promote Clostridium difficile-associated diarrhea.
- The in vitro and clinical data do not support a causal relationship between ciprofloxacin and CDAD.
- Further research may be warranted, but current evidence suggests ciprofloxacin is a relatively safe option regarding CDAD.