Review of Preclinical Studies with Ofloxacin

Sanders, Christine C.

doi:10.1093/clinids/14.2.526

Cited by 24 publications

(10 citation statements)

References 173 publications

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“…Howeverthis emergence is reported to be uncommonin ciprofloxacin (14,15). Indeed patients who repeatedly responded to new courses of ciprofloxacin treatment have been reported (16,17).…”

Section: Discussionmentioning

confidence: 99%

Metronidazole Plus Ciprofloxacin Therapy for Active Crohn's Disease

et al. 2003

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Objective The aim of this study was to investigate the efficacy of metronidazole plus ciprofloxacin for the treatment of Japanese patients with active Crohn's disease. Methods and Patients Seven patients (counting one patient twice with 2 enrollments at a 5-month interval) with a flare-up of Crohn's disease were enrolled. While continuing the baseline treatment under which the patients relapsed, they received metronidazole 250 mg twice (4 patients) or three times (3 patients) daily plus ciprofloxacin 200 mg three times daily for 4 weeks. The efficacy was evaluated by the changes in the assessment score of IOIBD, the International Organization for the Study of Inflammatory Bowel Disease, and the inflammation markers: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count. ResultsMetronidazole plus ciprofloxacin decreased the CRPin seven patients and the IOIBDscore in six patients. Significant differences were detected in these parameters at weeks 2 and 4 compared with baseline. Five of the patients achieved normalization of CRPand a reduction of the IOIBDscore to zero or one. Although one patient complained of taste disturbance, no other adverse events occurred and all patients completed the 4 weeks of study medication. Conclusion The addition of metronidazole plus ciprofloxacin could be a useful intervention for the treatment of Japanese patients with active Crohn's disease. (Internal Medicine 42: 318-321, 2003)

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“…Howeverthis emergence is reported to be uncommonin ciprofloxacin (14,15). Indeed patients who repeatedly responded to new courses of ciprofloxacin treatment have been reported (16,17).…”

Section: Discussionmentioning

confidence: 99%

Metronidazole Plus Ciprofloxacin Therapy for Active Crohn's Disease

et al. 2003

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“…Ofloxacin, a fluoroquinolone, has a broad range of in vitro activity against both gramnegative and gram-positive aerobic bacteria [1], The activity is little influenced by most testing parameters such as medium, inoculum size or presence of serum [2], Ofloxacin is very effectively absorbed from the gastrointestinal tract, and peak plasma levels are reached rap idly. With relatively low protein binding, rapid body tissue penetration and a mean elimina tion half-life of 5-8 h, ofloxacin has been a clinical success [3], In Canada, ofloxacin has been commer cially available for about 24 months, while ci profloxacin and norfloxacin have been avail able for 5 and 8 years, respectively.…”

Section: Introductionmentioning

confidence: 99%

Canadian Ofloxacin Susceptibility Study: A Comparative Study from 18 Medical Centers

Hoban

Jones²

1995

Chemotherapy

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Ofloxacin, a newer fluorinated 4-quinolone having a broad spectrum of activity was evaluated against 5,553 clinical pathogens isolated from urine, respiratory tract, skin and genital tract infections at 18 Canadian Medical Centers spread across the nation. Approximately 300 strains were reported (zone diameters) from each site. The zones of ofloxacin, other fluoroquinolones, oral cephalosporins and penicillins were analyzed and interpreted by NCCLS criteria. Ofloxacin had the widest spectrum of activity against gram-positive organisms and most gram-negative organisms, while ciprofloxacin was only superior for the Pseudomonas spp. The percentage of isolates susceptible to ofloxacin was as follows: for respiratory tract pathogens = 94%, for skin and soft tissue infections = 94%, for urinary tract organisms = 93% and for genital tract isolates = 94%.

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“…Common pathogens exhibit a wide range of susceptibilities to ciprofloxacin (10,21,27,31,39). The MICs for a large group of bacteria, typically Haemophilus and Moraxella species and most of the members of the family Enterobacteriaceae, are low (<0.08 to 0.25 ,ug/ml).…”

mentioning

confidence: 99%

Pharmacodynamics of intravenous ciprofloxacin in seriously ill patients

Forrest

Nix

Ballow

et al. 1993

Antimicrob Agents Chemother

1,029

750

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Seventy-four acutely ill patients were treated with intravenous ciprofloxacin at dosages ranging between 200 mg every 12 h and 400 mg every 8 h. A population pharmacokinetic-pharmacodynamic analysis relating drug exposure (and other factors) to infectious outcome was performed. Plasma samples were obtained and assayed for ciprofloxacin by high-performance liquid chromatography. Samples from patients were frequently cultured so that the day of bacterial eradication could be determined. The pharmacokinetic data were fitted by iterative two-stage analysis, assuming a linear two-compartment model. Logistic regression was used to model ciprofloxacin exposure (and other potential covariates) versus the probabilities of achieving clinical and microbiologic cures. The same variables were also modelled versus the time to bacterial eradication by proportional hazards regression. The independent variables considered were dose, site of infection, infecting organism and the MIC for it, percent time above the MIC, peak, peak/MIC ratio, trough, trough/MIC ratio, 24-h area under the concentration-time curve (AUC), AUC/MIC ratio (AUIC), presence of other active antibacterial agents, and patient characteristics. The most important predictor for all three measures of ciprofloxacin pharmacodynamics was the AUIC. A 24-h AUIC of 125 SIT-' h (inverse serum inhibitory titer integrated over time) was found to be a significant breakpoint for probabilities of both clinical and microbiologic cures. At an AUIC below 125 (19 patients), the percent probabilities of clinical and microbiologic cures were 42 and 26%, respectively. At an AUIC above 125 (45 patients), the probabilities were 80%o (P < 0.005) and 82% (P < 0.001), respectively. There were two significant breakpoints in the time-to-bacterialeradication data. At an AUIC below 125 (21 patients), the median time to eradication exceeded 32 days; at an AUIC of 125 to 250 (15 patients), time to eradication was 6.6 days; and at AUIC above 250 (28 patients), the median time to eradication was 1.9 days (groups differed; P < 0.005). These findings, when combined with pharmacokinetic data reported in the companion article, provide the rationale and tools needed for targeting the dosage of intravenous ciprofloxacin to individual patients' pharmacokinetics and their bacterial pathogens' susceptibilities. An a priori dosing algorithm (based on MIC, patient creatinine clearance and weight, and the clinician-specified AUIC target) was developed. This approach was shown, retrospectively, to be more precise than current guidelines, and it can be used to achieve more rapid bacteriologic and clinical responses to ciprofloxacin, as a consequence of targeting the AUIC.

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Review of Preclinical Studies with Ofloxacin

Cited by 24 publications

References 173 publications

Metronidazole Plus Ciprofloxacin Therapy for Active Crohn's Disease

Metronidazole Plus Ciprofloxacin Therapy for Active Crohn's Disease

Canadian Ofloxacin Susceptibility Study: A Comparative Study from 18 Medical Centers

Pharmacodynamics of intravenous ciprofloxacin in seriously ill patients

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