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Ciprofloxacin and Clostridium difficile-associated diarrhoea
C L Golledge1, C F Carson, G L O'Neill
1Central Microbiological Laboratories, Western General Hospital, Edinburgh UK.
The Journal of Antimicrobial Chemotherapy
|August 1, 1992
Summary
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.