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Related Experiment Videos

Do we need an intravenous fluoroquinolone?

D S Maddix1, L Warner

  • 1Pharmacy Service, VA Medical Center, San Francisco, CA 94121.

The Western Journal of Medicine
|July 1, 1992
PubMed
Summary

Intravenous ciprofloxacin is effective for nosocomial infections but raises concerns about bacterial resistance, particularly in Pseudomonas aeruginosa and staphylococci. Reserve parenteral fluoroquinolones for specific gram-negative infections when standard treatments fail.

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Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Microbiology

Background:

  • Intravenous ciprofloxacin is a parenteral fluoroquinolone for treating nosocomial infections.
  • Fluoroquinolones inhibit bacterial DNA gyrase, exhibiting bactericidal activity.
  • They are effective against Gram-negative bacteria and methicillin-susceptible staphylococci, but less so against anaerobes and streptococci.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous ciprofloxacin in treating nosocomial infections.
  • To highlight concerns regarding the development of bacterial resistance to fluoroquinolones.
  • To define the appropriate use of parenteral fluoroquinolones.

Main Methods:

  • Review of clinical trials comparing ciprofloxacin with ceftazidime for Gram-negative infections.
  • Analysis of in vitro activity against various bacterial species.
  • Assessment of reported side effects and drug interactions.

Main Results:

  • Ciprofloxacin demonstrated efficacy comparable to ceftazidime in treating Gram-negative bacterial infections.
  • Rapid development of bacterial resistance is a significant concern, especially in Pseudomonas aeruginosa and staphylococci.
  • Resistance is more common in chronic infections or with poor drainage, necrotic tissue, or catheters.
  • Adverse events include seizures and allergic reactions; concurrent use with theophylline can be dangerous.

Conclusions:

  • Parenteral fluoroquinolones, including ciprofloxacin, should be reserved for Gram-negative infections where standard agents are unsuitable.
  • Judicious use is necessary to mitigate the rapid emergence of bacterial resistance.
  • Physicians must weigh the benefits against the risks, including potential side effects and drug interactions.

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