The pharmacokinetics and safety of orally administered ciprofloxacin (Bay o 9867) were examined in 12 healthy male volunteers who received sequential doses of 250, 500, 750, and 1,000 mg. The individual and mean data were best described by biexponential disposition and elimination, assuming an apparent zero-order rate of absorption. The peak serum concentrations deterrmined from the individual data occurred at approximately 1.5 h after each dose and ranged from 0.42 to 4.2 ,ug/ml; the mean peak concentrations increased in proportion to the dose. The areas under the curve determined from the mean data were also proportional with respect to dose. The mean elimination half-lives calculated from pooled data were 4.1, 4.1, 6.9, and 6.3 h for doses of 250, 500, 750, and 1,000 mg, respectively. Longer half-lives but proportional area-under-the-curve values after the 750-and 1,000-mg doses implied that smaller fractions of ciprofloxacin were absorbed after these doses, although nonlinear kinetics could not be ruled out. The mean serum concentrations 12 and 24 h following each dose were -0.08 and 0.01 ,ug/ml, respectively. The urinary concentrations ranged from 30 to 500 ,ug/ml for at least 12 h after administration and were -9 ,ug/ml at 24 h following each dose. The urinary recovery level of unchanged ciprofloxacin over a 24-h period ranged from 28 to 44%. The mean renal clearances for each dose ranged from 300 to 500 ml/min. Ciprofloxacin was well tolerated, and no significant clinical or laboratory abnormalities were observed.Ciprofloxacin (Bay o 9867), a new quinolone derivative that is chemically related to nalidixic acid and norfloxacin, is currently undergoing microbiologic, pharmacokinetic, and clinical evaluation. The MICs of ciprofloxacin for 90% of the Enterobacteriaceae, Pseuidomnonas aeruiiginiosa, Hatemophiluis influenzae, Staphylococcus aureiis (including methicillin-resistant S. aiureuts), streptococcal, and Btacteroidesfragilis strains which have been tested including strains resistant to gentamicin and many third gei eration cephalosporins, range from 0.008 to 2.0 jig/ml (3,6,13).Ciprofloxacin was originally developed as an oral agent similar to nalidixic acid for the treatment of urinary tract infections. However, due to its excellent activity against gram-negative bacteria, development of a parenteral product is currently underway for use in the treatment of systemic bacterial infections. The purpose of this study was to determine the pharmacokinetic disposition and tolerance of orally administered ciprofloxacin in healthy volunteers after sequential increasing doses.
MATERIALS AND METHODSSixteen healthy males (ages 22 to 26 years) were randomly selected to receive either ciprofloxacin (12 subjects) or a placebo (4 subjects). Before the study and before each of the four weekly doses, all of the subjects underwent physical examinations, including electrocardiograms, complete blood counts, platelet counts, a panel of 20 serum chemistry tests, urinalysis, and a stool test for occult blood. Another examin...