Treatment of serious infections with intravenous ciprofloxacin. French Multicenter Study Group
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1Department of Infectious Diseases, Saint Louis Hospital, Paris, France.
Abstract:
Ninety-four patients, 61 men and 33 women with a mean age of 54 years, were treated with intravenous ciprofloxacin. Eighty-one patients (86 percent) were in serious or fair condition. Pathogens included Enterobacteriaceae (74 patients), Pseudomonas sp. (23 patients), other gram-negative bacilli (five patients), staphylococci (19 patients), other gram-positive cocci (seven patients), and Rickettsia conorii (five patients). Thirty-eight patients were given parenteral therapy (ciprofloxacin at a mean daily dose of 200 mg every 12 hours, mean duration of therapy, nine days). Fifty-six patients were also given ciprofloxacin orally after initial intravenous therapy at a dose of either 500 or 750 mg every 12 hours (mean duration of therapy, 36 days). Another antibiotic was given concomitantly in 25 cases (27 percent). The overall clinical response was 93 percent and the bacteriologic response rate was 84 percent. There was no difference between patients treated by intravenous ciprofloxacin and those treated by intravenous ciprofloxacin followed by oral ciprofloxacin. Favorable responses (resolution of improvement) were observed in 39 of 42 patients (93 percent) with bacteremia, 28 of 30 (93 percent) with urinary tract infection, 10 of 13 (77 percent) with respiratory tract infection, 11 of 12 (92 percent) with bone and joint infection, three of three (100 percent) with skin and soft-tissue infection, nine of nine (100 percent) with intra-abdominal infection, three of three (100 percent) with typhoid fever, and two of two (100 percent) with meningitis. All five patients with R. conorii infections had a response to therapy. The adverse effects were minor and transient. Seven patients experienced clinical adverse effects: pain at the injection site (three patients), rash (two patients), and headache (2 patients). Serum transaminase levels were increased in 11 patients. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections.
Insights
Intravenous ciprofloxacin effectively treats serious bacterial infections, showing high clinical and bacteriologic response rates. This antibiotic therapy, whether IV alone or followed by oral administration, proved safe and well-tolerated in patients.
Area of Science:
- Infectious Diseases
- Pharmacology
- Internal Medicine
Background:
- Serious bacterial infections pose significant clinical challenges.
- Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic with established efficacy.
- Evaluating intravenous and sequential oral-intravenous ciprofloxacin regimens is crucial for optimizing treatment.
Purpose of the Study:
- To assess the safety and efficacy of intravenous ciprofloxacin in treating serious infections.
- To compare the outcomes of intravenous ciprofloxacin with a sequential intravenous-oral regimen.
- To evaluate the response rates across various types of bacterial infections.
Main Methods:
- Ninety-four patients with serious infections were treated with intravenous ciprofloxacin.
- A subset received subsequent oral ciprofloxacin therapy.
- Clinical and bacteriologic responses, along with adverse effects, were monitored.
Main Results:
- An overall clinical response rate of 93% and a bacteriologic response rate of 84% were observed.
- High response rates were noted across diverse infections, including bacteremia, UTIs, and bone/joint infections.
- Adverse effects were minor and transient, with no significant difference between treatment arms.
Conclusions:
- Intravenous ciprofloxacin, alone or followed by oral administration, is a safe and effective treatment for serious infections.
- The sequential intravenous-oral regimen demonstrated comparable efficacy to intravenous-only therapy.
- Ciprofloxacin offers a favorable safety profile for managing a wide spectrum of bacterial pathogens.