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A Survey of Clinical Experience with Ciprofloxacin, a New Quinolone Antimicrobial
Author(s) -
Arcieri George,
Griffith Elizabeth,
Gruenwaldt Gert,
Heyd Allen,
O'Brien Barbara,
Screen Phillip,
Becker Nancy,
August Rita
Publication year - 1988
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1988.tb05741.x
Subject(s) - ciprofloxacin , superinfection , medicine , antimicrobial , pseudomonas aeruginosa , quinolone , antibiotics , urinary system , levofloxacin , respiratory tract infections , ofloxacin , gastroenterology , microbiology and biotechnology , immunology , biology , respiratory system , bacteria , virus , genetics
Ciprofloxacin is a new quinolone antimicrobial agent with activity against a broad spectrum of gram‐negative and gram‐positive organisms, including Pseudomonas aeruginosa and methicillin‐resistant strains of staphylococci. The efficacy and safety results of 80 clinical studies of the oral form of ciprofloxacin are reported. Drug safety was assessed in 2236 courses in 2203 adult patients treated primarily in the Unites States. Data from 1676 courses were suitable for analysis of drug efficacy. The unit dose for most patients ranged from 250 mg to 750 mg (median, 500 mg), usually given every 12 hours. The duration of treatment ranged from 3 to 231 days (median, 10 days). Predominant among 1722 infections were those of the urinary tract (43%), skin structures (29%), and respiratory tract (19%); the remainder were bone and joint infections (5%), bacteremias (2%), and intra‐abdominal (1%), gastrointestinal (1%), and pelvic infections (<1%). Signs and symptoms of infection resolved in 79% of all cases; a further 15% improved, and 5% failed to improve. Pathogens were eradicated in 89% of urinary tract infections and persisted in 5%; 80% of patients still had sterile urine at the 3‐ to 6‐week follow‐up. In 81% of nonurinary tract infections, pathogens were eradicated; they persisted in 11%, and superinfection occurred in less than 5%. After treatment, 89% of the 2253 causative organisms were eradicated and 2% were reduced to clinically insignificant counts; 8% persisted. Of 411 isolates of P. aeruginosa, 77% were eradicated, as were 97% of 421 Escherichia coli and 80% of 248 Staphylococcus aureus isolates. Also eradicated were 95% of 166 Klebsiella, 96% of 139 Proteus mirabilis, 100% of 20 other Proteus, 94% of 123 Enterobacter, 100% of 68 Haemophilus influenzae, 96% of 49 Citrobacter, 89% of 45 Serratia, 95% of 41 Streptococcus pneumoniae, 91% of 43 Salmonella, 100% of 38 Morganella morganii, and 100% of 35 Providencia isolates. Adverse reactions were judged probably or possibly drug‐related in 14.8% of courses; drug treatment had to be stopped prematurely in 3.5%. The most frequent reactions were gastrointestinal complaints (chiefly nausea, diarrhea, and vomiting), metabolic disorders (elevated SGOT, SGPT, serum creatinine, or blood urea nitrogen), and nervous system effects (dizziness, light‐headedness, restlessness, tremor, and headache). Crystalluria, judged to be related to ciprofloxacin, occurred in two patients. In controlled trials, oral ciprofloxacin proved to be at least as effective and safe a treatment as trimethoprim/sulfamethoxazole in urinary tract infection, ampicillin in lower respiratory tract infection, and intravenously administered cefotaxime in skin structure infection .