Oral Ciprofloxacin Therapy of Infections Due to Pseudomonas Aeruginosa

Scully, BrianE.; Parry, MichaelF.; Neu, H C; Mandell, William

doi:10.1016/s0140-6736(86)90937-2

Cited by 154 publications

(83 citation statements)

References 10 publications

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“…A possible interaction between ciprofioxacin and theophylline was also reported by Scully & Neu (1985). In both studies the ciprofloxacin dose was higher than the dose used in this study.…”

supporting

confidence: 73%

The influence of quinolone derivatives on theophylline clearance.

Wijnands¹,

Vree²,

Herwaarden³

1986

Brit J Clinical Pharma

242

118

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1 Enoxacin decreases the metabolic clearance of the bronchodilator theophylline not only in severely ill patients, but also in patients with stable chronic obstructive airways disease.2 In this comparative study, significantly increased plasma theophylline concentrations were measured during co-administration of enoxacin (110.9%) and, to a lesser degree, also during co-administration of pefloxacin (19.6%) and ciprofloxacin (22.8%). 3 Total body clearance of theophylline was significantly decreased by enoxacin (63.6%), ciprofloxacin (30.4%) and pefloxacin (29.4%). The pharmacokinetic parameters of theophylline did not change during co-administration of ofloxacin and nalidixic acid. 4 There is growing evidence that the observed interaction is caused not by the parent drugs, but by the 4-oxo metabolite of enoxacin, pefloxacin and ciprofloxacin.Keywords quinolone 4-oxo quinolone enoxacin pefloxacin ciprofloxacin ofloxacin nalidixic acid theophylline interaction lower respiratory tract infections

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“…A possible interaction between ciprofioxacin and theophylline was also reported by Scully & Neu (1985). In both studies the ciprofloxacin dose was higher than the dose used in this study.…”

supporting

confidence: 73%

The influence of quinolone derivatives on theophylline clearance.

Wijnands¹,

Vree²,

Herwaarden³

1986

Brit J Clinical Pharma

242

118

View full text Add to dashboard Cite

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“…Although this result was formally statistically insignificant, we detected this tendency in all analyses performed. Our failure risk of 24% is congruent with the 20% [12], 21% [13], 25% [27], 27% [14] or 30% [9] failure rates reported for pseudomonal osteoarticular infections, although lower (5% [11]; 7% [21]) or higher failure rates ranging from 33% [23], 35% [24], 38% [22] to 39% [15] also exist in small case series from the 1980s. Development of resistance among failure cases to the antimicrobial agents used during therapy occurred in 15%, which is congruent with the 13-24% risk after a prolonged antibiotic monotherapy during three-four months [9,24].…”

Section: Discussionsupporting

confidence: 85%

“…(2) Recurrences of osteomyelitis after several years, if not decades, have been reported [36] and there is no internationally accepted minimal follow-up duration. In the literature, minimal follow-up times range from three [16] to six months [21,25,26] or one [12,22,23] to two years [9,10]. Hence, we consider our individual minimal and median follow-up times of 1.5 and four years as a strong point of our study.…”

Section: Or Longermentioning

confidence: 99%

“…P. aeruginosa accounts for an absolute minority of all osteoarticular pathogens [1], and most reports are either case series involving around 20-30 cases [9][10][11][12][13] or even less [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Moreover, these reports subsume P. aeruginosa under other Gram-negative pathogens [9,12,13,19], including anaerobes [10,28], and lack adjustment for case mix [9,10,19,21].…”

Section: Introductionmentioning

confidence: 99%

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Remission after treatment of osteoarticular infections due to Pseudomonas aeruginosa versus Staphylococcus aureus: a case-controlled study

Seghrouchni

Delden

Dominguez

et al. 2011

International Orthopaedics (SICOT)

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Purpose Osteoarticular infections due to methicillinsusceptible Staphylococcus aureus (MSSA) or its methicillin-resistant variant (MRSA) are feared due to treatment failures. According to clinical experience, Pseudomonas aeruginosa may reveal less long-term remission than S. aureus. Methods A case-controlled study comparing outcomes of osteoarticular infections due to P. aeruginosa vs S. aureus was performed at Geneva University Hospitals. Results A total of 111 S. aureus (including 37 MRSA) and 20 P. aeruginosa osteoarticular infections were analysed in 131 patients: arthroplasties (n=38), fracture fixation devices (n=56), native joint arthritis (n=7) and osteomyelitis without implant (n=30). The median active follow-up time was 4 years. The patients underwent a median number of two surgical interventions for P. aeruginosa infections compared to two for S. aureus (two for MRSA), while the median duration of antibiotic treatment was 87 days for P. aeruginosa and 46 days for S. aureus infections (58 days for MRSA) (all p>0.05). Overall, Pseudomonas-infected patients tended towards a lower remission rate than those infected with S. aureus (12/20 vs 88/111; p=0.06). This was similar when P. aeruginosa was compared with MRSA alone (12/20 vs 30/37; p=0.08). In multivariate logistic regression analyses adjusting for case mix, odds ratios (OR) for remission were as follows: P. aeruginosa vs S. aureus [OR 0.4, 95% confidence interval (CI) 0.1-1.2], number of surgical interventions (OR 0.6, 95% CI 0.5-1.0) and duration of antibiotic treatment (OR 1.0, 95% CI 1.0-1.0). Conclusions Despite a similar number of surgical interventions and longer antibiotic treatment, osteoarticular infections due to P. aeruginosa tended towards a lower remission rate than infections due to S. aureus in general or MRSA in particular.

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“…A total of 26 patients with UTI due to P. aeruginosa were treated with ciprofloxacin (1,000 mg daily) usually for 10 days in three open studies that included other infections [27,29,30]. Ninety-two percent of these patients were cured, but the follow-up period was only 1 week.…”

Section: And Van Saenementioning

confidence: 99%

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

Malinverni¹,

Glauser²

1988

Clinical Infectious Diseases

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The resultsof comparative trials of fluoroquinolones for the treatment of uncomplicated and complicated urinary tract infections (UTI) were reviewed. Severalrandomized, comparative trials showedthat in uncomplicated UTI norfloxacin, ciprofloxacin, and ofloxacin wereat least as effectiveas trimethoprim-sulfamethoxazole (TMP-SMZ) and amoxicillinand usually more effectivethan nalidixicacid, pipemidic acid, and nitrofurantoin. Comparativetrials of single-dose regimens have, however, been limited. A few randomized, comparative trials have shown that in complicated UTI norfloxacin, ciprofloxacin, and ofloxacin wereat least as effectiveas amoxicillinand TMP-SMZand usually more effective than pipemidic acid. Moreover, preliminary results indicate that fluoroquinolones might be effective for the oral treatment of complicated UTI that are difficult to treat, especially those due to Pseudomonas aeruginosa. Comparative trials are needed to establish the value of fluoroquinolones for chronic bacterial prostatitis. There are no conclusivedata on fluoroquinolone treatment of UTI in patients with renal failure. Emergence of resistantpathogens during therapywith fluoroquinolones has beeninfrequentbut might be more frequent in complicated UTI caused by P. aeruginosa.Although highly effective and well-established antibiotic regimens are available for the treatment of urinary tract infection (UTI), there is a need for new antimicrobial agents, especially for the treatment of outpatients with UTI that are difficult to treat and for which most of the drugs available for oral treatment are ineffective.The fluoroquinolones have several properties that suggest their potential clinical utility for the treatment of UTI, including high activity in vitro against virtually all urinary tract pathogens and good absorption after oral administration that results in prolonged high levels of drug in urine [1].The methodologic problems associated with open and comparative trials evaluating the efficacy of new antibiotics for the treatment of UTI have recently been reviewed [2]. For this review of the efficacy of fluoroquinolones for the treatment of UTI, we have emphasized those studies that have both sufficient data for a clear classification of UTI and data on We thank Mrs. Kathrin Zsirmik and Mrs. Alexandra Bloch for typing the manuscript.Please address requests for reprints to R. Malinverni, Medizinische Universitatsklinik, Inselspital, CH-3010 Bern, Switzerland. follow-up urine cultures 4-6 weeks after the end of treatment (unless otherwise mentioned). In this evaluation, bacteriologic cure (sterile urine) was considered as the end point of antibiotic treatment since the definitions of clinical response, when stated, varied from one study to another and symptoms may disappear in the absence of bacteriologic cure. In table 1, which outlines the efficacy of fluoroquinolone treatment of UTI by infecting organism, only data from studies (noncomparative and comparative) that provided sufficient information to permit a clear classification of UTI...

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Oral Ciprofloxacin Therapy of Infections Due to Pseudomonas Aeruginosa

Cited by 154 publications

References 10 publications

The influence of quinolone derivatives on theophylline clearance.

The influence of quinolone derivatives on theophylline clearance.

Remission after treatment of osteoarticular infections due to Pseudomonas aeruginosa versus Staphylococcus aureus: a case-controlled study

Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections

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