Sequential intravenous/oral ciprofloxacin in the treatment of severe multiresistant gram-negative infections

Twenty-one patients with severe multiresistant gram-negative bacillary infections were treated with ciprofloxacin, intravenously followed by oral. The mean duration of therapy was 13 days. Causative organisms were Klebsiella pneumoniae (18 patients), Pseudomonas aeruginosa (2) and Salmonella enteritidis (1). The overall clinical improvement was 85 per cent, with a bacteriologic improvement of 90 per cent. Three patients died, one had fungemia, another had persistent bacteremia, and a third had progressive lung infiltration despite eradication of bacteremia. Superinfections occurred in 2 patients, and the other 2 had colonization of the wounds. It is shown that this treatment is effective and safe for the treatment of severe multiresistant gram-negative infections.