Antibacterial treatment of otitis and sinusitis with ciprofloxacin and penicillin V — A comparison

Abstract

80 adult outpatients suffering from otitis media, sinusitis (maxillaris or frontalis) or peritonsillitis were treated with 500 mg ciprofloxacin b.i.d. (n = 40) or with 2 g penicillin V t.i.d. (n = 40). The patients were randomly allocated. Three groups of patients resulted, clinically and bacteriologically evaluable, or only clinically evaluable because the isolated strains were resistant to ciprofloxacin or penicillin V or because no strains were isolated. Ciprofloxacin was superior to penicillin V; there were fewer resistant strains (one compared to 11), and the eradication rate (57% compared to 43%) as well as the clinical efficacy (60% compared to 48%) of ciprofloxacin were better than those of penicillin V--even in a daily dose of 6.0 g. Both treatments were well tolerated; side effects were neither reported nor found.

Ciprofloxacin plus fluocinolone acetonide versus ciprofloxacin alone in the treatment of diffuse otitis externa

“…5,6 Gentamicin ototoxicity and nephrotoxicity are well known. 9,10 Reduced bactericidal effect against Pseudomonas and Enterobacteriaceae has also been observed. 9,10 Reduced bactericidal effect against Pseudomonas and Enterobacteriaceae has also been observed.…”

“…It acts as an inhibitor of bacterial topoisomerase II (DNA gyrase) and its homologue topoisomerase IV, enzymes that are required for bacterial DNA replication, and has in vitro activity against a wide range of Gram-negative and Gram-positive bacteria. [8][9][10][11][12][13][14] However, the need to administer high doses to achieve acceptable tissue concentrations, with the consequent possibility of side effects and high costs, have led investigators to the idea of applying ciprofloxacin to the ear topically. Different trials have shown that ciprofloxacin, unlike aminoglycosides, does not show ototoxicity at the cochleovestibular level.…”

“…Gentamicin ototoxicity and nephrotoxicity are well known 2 – 4 , 15 . Gentamicin can cause auditory and vestibular problems on reaching the inner ear 9 , 10 . Reduced bactericidal effect against Pseudomonas and Enterobacteriaceae has also been observed 7 , 16 …”

Are amoxycillin and folate inhibitors as effective as other antibiotics for acute sinusitis? A meta-analysis

“…Most were ineligible for our meta-analysis: 48 did not use the reference drugs pertinent to this analysis, three inextricably combined patients with sinusitis with those with other infections,9 – 11 and two inextricably combined patients with acute, chronic, and recurrent sinusitis. 12 13 Of the 27 trials that qualified for our meta-analysis, six were placebo controlled (one study comparing amoxycillin also had a placebo arm),14 – 19 13 compared amoxycillin with other antibiotics, 16 20 – 31 and eight compared a folate inhibitor (co-trimoxazole, trimethoprim plus sulfametopyrazine, or brodimoprim) with other antibiotics 32 – 39.…”

Pharmacokinetics and Bioequivalence Study of Two Ciprofloxacin Hydrochloride Tablets in Chinese Healthy Volunteers Under Fasting and Fed Conditions: A Randomized, Open-Label, Two-Formulation, Two-Sequence, Two-Period, Single-Dose Crossover Study.

“…In addition to complicated urinary tract infections [5], gastrointestinal infections [6], gonorrhea [7], cipro oxacin was widely used in the therapy of lower respiratory tract infections [8], skin and soft tissue infections [9], sinusitis [10], otitis media [11], sepsis [12], etc. Cipro oxacin exhibits excellent antimicrobial activity against many pathogens, such as some Gram-positive organisms including staphylococci, streptococci, and most of Gram-negative organisms consisting of Hemophilus in uenzae, Escherichia coli, Enterobacter, P. aeruginosa species.…”