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[Clinical study of prulifloxacin on infectious enteritis. Japan Research Committee of Prulifloxacin, Research Group
I Tomizawa1, Y Takizawa, Y Nitta
1Department of Infectious Diseases, Minamigaoka Branch of Sapporo City General Hospital.
Abstract:
Prulifloxacin (PUFX), a new quinolone antimicrobial agent, was administered to a total of 122 patients and carriers to investigate its clinical efficacy, safety and usefulness in infectious enteritis (bacillary dysentery, enteritis caused by Salmonella spp. and enteropathogenic E. coli, cholera and so on). In addition, the minimum inhibitory concentration (MIC) of UFX (active compound) was determined against each clinical isolate, and compared with that of ciprofloxacin (CPFX), ofloxacin (OFLX), tosufloxacin (TFLX) and nalidixic acid (NA). The correlation between the concentration of UFX in feces and the change of the fecal microflora were also investigated when PUFX was administered to the patients with acute infectious enteritis. A daily dose of 400 mg of PUFX was administered orally in two divided doses (morning and evening) for 5 days, with the exception of 7 days administration against salmonella enteritis and 3 days administration against cholera. 84 cases were adapted for evaluating the usefulness. The clinical efficacy was 100% in all the enteritis except salmonella enteritis, in which it was 88.9% (8/9 cases). On the bacteriological efficacy, the elimination rate was 100% in all isolates except Salmonella spp., in which it was 75.0% (12/16 cases). As for the adverse effect, uriticaria in moderate degree was observed in 1 (0.9%) of 109 cases. Abnormal changes in laboratory findings were seen in 3 (3.0%) of 100 cases, consisting of 1 with eosinophilia and 2 with elevated S-GPT, although they were all slight in degree. The usefulness rate was 65.5% (55/84 cases) for "very useful" and 95.2% (80/84 cases) for "very useful" and "useful". MIC90 of UFX against Shigella spp., Salmonella spp., E. coli and V. cholerae, was 0.025, 0.05, 0.025 and 0.05 microgram/ml, respectively. These values were the same as those of CPFX and TFLX, and superior to OFLX and NA. UFX concentrations in feces followed by administration of PUFX in 3 cases with acute infectious enteritis were higher than that of MIC90 of UFX against Shigella spp., Salmonella spp., E. coli and V. cholerae. The changes of the fecal microflora, which influence the efficacy and safety of PUFX, were not observed.
Insights
Prulifloxacin (PUFX) demonstrated high clinical efficacy against infectious enteritis, with a 100% success rate in most cases. This new quinolone antimicrobial agent showed favorable safety and microbiological profiles in patient studies.
Area of Science:
- Microbiology
- Pharmacology
- Clinical Medicine
Background:
- Infectious enteritis remains a significant global health concern, necessitating effective antimicrobial agents.
- Quinolone antimicrobials are crucial in treating bacterial gastrointestinal infections.
- Prulifloxacin (PUFX) is a novel quinolone with potential therapeutic applications.
Observation:
- A study evaluated the clinical efficacy, safety, and usefulness of PUFX in 122 patients and carriers with infectious enteritis.
- Minimum inhibitory concentrations (MIC) of the active compound, UFX, were determined against key pathogens and compared to other quinolones.
- Fecal UFX concentrations and their correlation with fecal microflora changes were investigated in patients with acute infectious enteritis.
Findings:
- PUFX achieved 100% clinical efficacy against most enteritis types, including bacillary dysentery, E. coli, and cholera, with 88.9% efficacy against Salmonella enteritis.
- Bacteriological efficacy showed a 100% elimination rate for most isolates, except for Salmonella spp. (75.0%).
- Adverse effects were minimal, with only 0.9% experiencing urticaria, and minor laboratory abnormalities in 3.0% of cases. Usefulness was rated as "very useful" or "useful" in 95.2% of cases.
Implications:
- Prulifloxacin (PUFX) exhibits potent antimicrobial activity against common enteritis pathogens, comparable to ciprofloxacin and tosufloxacin.
- Achieved fecal concentrations of UFX exceeded MIC90 values, suggesting effective treatment levels.
- The study indicates PUFX is a safe and effective option for treating infectious enteritis with no significant adverse impact on fecal microflora.