Comparative pharmacokinetics of intravenous ofloxacin and ciprofloxacin

Lode, H.; Höffken, G.; Olschewski, Peter; Sievers, B.; Kirch, Andreas; Börner, K.; Koeppe, P.

doi:10.1093/jac/22.supplement_c.73

Cited by 14 publications

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“…Ciprofloxacin was administered at different doses depending on the site of infection and the type of infectious agent. Even in the group of patients with normal or only slightly impaired renal function, the average half‐life was enhanced when compared with healthy volunteers (4, 14, 21, 23, 30). In the group of patients treated with CVVH (group I), the average half‐life and the average MRT were similar to those in patients with approximately normal renal function (group II).…”

Section: Discussionmentioning

confidence: 95%

“…To establish an effective dosage, a maximum concentration to minimal inhibitory concentration (Cmax:MIC) ratio of about 10 and an area under the curve to minimal inhibitory concentration (AUC 0 – 24 h:MIC) of about 100 has been suggested (22, 29). For critically ill patients, 400 mg t. i. d. have been suggested (23). A dose of 600 mg t. i. d. administered intravenously was recommended for patients with major burns and normal renal function (21).…”

Section: Discussionmentioning

confidence: 99%

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Pharmacokinetics of Ciprofloxacin in Patients with Acute Renal Failure Undergoing Continuous Venovenous Haemofiltration: Influence of Concomitant Liver Cirrhosis

et al. 2002

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To determine an adequate dosage of ciprofloxacin in critically ill medical patients on continuous venovenous haemofiltration, we studied the pharmacokinetics of ciprofloxacin in eight critically ill medical patients with renal failure treated with continuous venovenous haemofiltration using polysulfone membranes. Three of those patients also presented with severe liver dysfunction. For comparison, three patients with approximately normal renal function and two patients with impaired renal function were included. During haemofiltration, plasma concentrations of ciprofloxacin were variable. In all critically ill patients ciprofloxacin elimination was significantly slowed; the mean half-life was similarly prolonged to about 14 h in patients on haemofiltration and those with approximately normal renal function. In critically ill patients with impaired renal function not on haemofiltration, the mean half-life was longest. Ciprofloxacin clearance by haemofiltration was a quarter of the total clearance. Although a unique dose recommendation can hardly be made because of the high variability of pharmacokinetics during haemofiltration, a daily dose of 800 mg (400 mg b.i.d.) in average can be regarded as appropriated for reaching a target plasma concentration of 2 to 3 micrograms/mL (mean concentration). Because the half-life of ciprofloxacin was further prolonged by the presence of liver cirrhosis, the dose should be reduced to 600 mg in patients on haemofiltration with concomitant severe liver dysfunction.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of Ciprofloxacin in Patients with Acute Renal Failure Undergoing Continuous Venovenous Haemofiltration: Influence of Concomitant Liver Cirrhosis

et al. 2002

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“…Other trials have compared the pharmacokinetics of ciprofloxacin and ofloxacin (2,11,17,(25)(26)(27), although this is the first to compare multiple oral doses. Results from the present study are consistent in finding that ofloxacin (400 mg) achieves higher serum concentrations and has a longer half-life, higher AUC, and greater urinary recovery after oral administration than ciprofloxacin (500 and 750 mg).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and serum bactericidal titers of ciprofloxacin and ofloxacin following multiple oral doses in healthy volunteers

Israel

Gillum

Turik

et al. 1993

Antimicrob Agents Chemother

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Fourteen adult males participated in a randomized three-way crossover study to compare the pharmacokinetics and serum bactericidal titers (SBTs) of 500 mg of ciprofloxacin (regimen A), 750 mg of ciprofloxacin (regimen B), and 400 mg of ofloxacin (regimen C) administered every 12 h for seven doses. Mean steady-state peak concentrations in serum for regimens A, B, and C were 3.0, 4.4, and 6.5 ,g/ml, respectively (P < 0.01, all comparisons) and mean half-lives were 4.5, 4.3, and 6.5 h, respectively (P < 0.05, C versus A and B). Mean steady-state areas under the concentration-time curve were 14.1, 21.1, and 48.1 ,g/h/ml for regimens A, B, and C, respectively (P < 0.05, all comparisons). SBTs were determined at different times postdose for three isolates each of Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coi, Enterobacter cloacae, and Pseudomonas aeruginosa. Mean steady-state peak SBTs for regimens A, B, and C, respectively, were as follows: S. pneumoniae, <1:2, 1:8, 1:8; S. aureus, 1:16, 1:16, 1:16; E. coli, 1:2 128, 1:2 128, 1:64; E. cloacae, 1:2 128, 1:2 128, 1:64; P. aeruginosa, 1:8, 1:8, 1:2. These differences in SBTs within each genus were statistically significant. The majority of predicted SBTs were within one dilution of measured SBTs. Areas under the serum bactericidal time curves forE. coli, E. cloacae, and P. aeruginosa were significantly higher for ciprofloxacin; areas under the serum bactericidal time curves for S. pneumoniae and S. aureus were significantly greater for ofloxacin. Ofloxacin achieved higher concentrations in serum than ciprofloxacin, but differences in in vitro activity were a more important determinant of SBTs.Ciprofloxacin and ofloxacin are fluoroquinolone antibiotics which are well absorbed by the oral route and are active against a broad range of pathogenic bacteria (7). Since these quinolones differ in both pharmacokinetics and in vitro activity, measurement of serum bactericidal titers (SBTs) integrates both characteristics and allows for direct comparison of their pharmacodynamic properties (1,4,16). The purpose of this study was to compare the pharmacokinetics and SBTs of ciprofloxacin and ofloxacin in healthy volunteers after multiple-dose oral administration.(A portion of this manuscript appeared as an abstract in the program of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy, Anaheim, Calif., October 1992 [6a].)

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“…The fluoroquinolone group of antibiotics have been expanded to include agents with an increased spectrum of activity, greater penetration and bioavailability, a longer serum half-life and a decreased selec tion of resistant bacteria [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

The Comparative Activity of Fleroxacin, Three Other Quinolones and Eight Unrelated Antimicrobial Agents

McCarter

Mazens-Sullivan²,

Bartlett³

1992

Chemotherapy

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The in vitro activity of fleroxacin, a new trifluorinated quinolone was evaluated against 432 bacterial isolates. Fleroxacin was 1- to 2-fold less active than ciprofloxacin and at least as active as ofloxacin and lomefloxacin against most members of the family Enterobacteriaceae. The MICs of fleroxacin for 90% of strains tested (MIC₉₀) were ≤0.25 μg/ml against all isolates of Enterobacteriaceae except Citrobacter freundii (MIC₉₀, 4 μg/ml) and Serratia marcescens (MIC₉₀, 2 μg/ml). Fleroxacin was as active as ciprofloxacin, ofloxacin and lomefloxacin against Pseudomonas spp, (MIC₉₀ for all quinolones tested were > 8 μg/ml). Acinetobacter and Haemophilus influenzae were very susceptible to fleroxacin; however fleroxacin was 1-fold less active than lomefloxacin against Acinetobacter and at least 1-fold less active than ciprofloxacin or ofloxacin against H. influenzae. Methicillin-susceptible and -resistant strains of Staphylococcus epidermidis and methicillin-susceptible strains of S. aureus were very susceptible to fleroxacin, with an MIC₉₀≤1 μg/ml (range 0.5-1 μg/ml). Methicillin-resistant S.aureus and Staphylococcus spp. other than aureus and epidermidis were not susceptible to fleroxacin (MIC₉₀ > 8 μg/ml). In addition, fleroxacin as well as ciprofloxacin, ofloxacin and lomefloxacin were inactive against Enterococcus spp. (MIC₉₀ > 8 μg/ml). Streptococcus pneumoniae and S. pyogenes were resistant to both fleroxacin and lomefloxacin but were very susceptible to ciprofloxacin and ofloxacin. These results suggest that fleroxacin represents a valid therapeutic option in the treatment of infections caused by most Enterobacteriaceae and some species of staphylococcus.

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Comparative pharmacokinetics of intravenous ofloxacin and ciprofloxacin

Cited by 14 publications

References 0 publications

Pharmacokinetics of Ciprofloxacin in Patients with Acute Renal Failure Undergoing Continuous Venovenous Haemofiltration: Influence of Concomitant Liver Cirrhosis

Pharmacokinetics of Ciprofloxacin in Patients with Acute Renal Failure Undergoing Continuous Venovenous Haemofiltration: Influence of Concomitant Liver Cirrhosis

Pharmacokinetics and serum bactericidal titers of ciprofloxacin and ofloxacin following multiple oral doses in healthy volunteers

The Comparative Activity of Fleroxacin, Three Other Quinolones and Eight Unrelated Antimicrobial Agents

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