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Ciprofloxacin: in vitro, experimental, and clinical evaluation
H Thadepalli1, M B Bansal, B Rao
1Department of Medicine, Charles R. Drew Postgraduate Medical School, Los Angeles, California 90059.
Reviews of Infectious Diseases
|May 1, 1988
Summary
Ciprofloxacin effectively inhibited aerobic bacteria from septicemic patients. In clinical trials, oral ciprofloxacin showed comparable efficacy to intravenous cefotaxime for skin infections, with better outcomes for gram-negative infections but poorer for Staphylococcus aureus.
Area of Science:
- Microbiology
- Pharmacology
- Clinical Medicine
Background:
- Ciprofloxacin is a fluoroquinolone antibiotic with broad-spectrum activity.
- Bacterial resistance and treatment efficacy are key concerns in managing septicemia and skin infections.
Purpose of the Study:
- To evaluate the in vitro activity of ciprofloxacin against aerobic bacteria from septicemic patients.
- To assess the in vivo efficacy of ciprofloxacin in a mouse abscess model.
- To compare the therapeutic efficacy of oral ciprofloxacin with intravenous cefotaxime in treating severe skin and soft-tissue infections.
Main Methods:
- In vitro susceptibility testing of ciprofloxacin against 584 bacterial strains.
- Mouse subcutaneous abscess model to compare ciprofloxacin and cefotaxime.
- Double-blind, prospective, randomized clinical trial in hospitalized patients with skin infections.
Main Results:
- Ciprofloxacin (2 µg/mL) inhibited ~90% of aerobic bacteria from septicemic patients.
- Serial passage increased minimum inhibitory concentration (MIC) for E. coli, K. pneumoniae, and P. vulgaris.
- In vivo, ciprofloxacin was more active than cefotaxime against E. coli/B. fragilis; comparable against E. coli/S. aureus.
- Clinical study: Oral ciprofloxacin efficacy comparable to IV cefotaxime; 92% vs 64% for gram-negative, 62% vs 90% for S. aureus.
Conclusions:
- Ciprofloxacin demonstrates significant in vitro activity against key pathogens in septicemia.
- Ciprofloxacin shows promise in treating mixed bacterial infections and certain skin infections.
- Treatment outcomes vary by pathogen, with superior efficacy against aerobic gram-negative bacteria but less favorable results for S. aureus infections.