Worldwide clinical data on efficacy and safety of ciprofloxacin

Abstract

During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra-abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient.

Antibiotic Cover of Transurethral Maneuvers with Ciprofloxacin and Susceptibility Behavior of Pathogens in Patients with Neurogenic Bladder

“…As already shown, alkaline urine seems to improve the bacteriological efficacy in spite of the potential emergence of ciprofloxacin crystals [1,2,8], a fact observed extremely rarely in 3 of 8,861 patients [9], This efficacy is confirmed by the present study show ing an eradication of Proteus strains in alkaline urine in spite of an indwelling catheter.…”

Occurrence of quinolone resistance inStaphylococcus aureusfrom nosocomial infection

“…The concentrations of quinolones at which resistant mutants of bacteria can be isolated in vitro are 8-16-fold lower than the MIC's for quinolones after subcultivation of these mutants [6]. Reports on the emergence of quinolone-resistant clinical isolates of S. aureus and Pseudomonas aeruginosa together with therapeutic use correspond to these observations [7,8]. The emergence of quinolone resistance is of particular concern in the case of MRSA for which relatively few antimicrobial agents are still effective.…”

Fluoroquinolone antimicrobial agents

“…Most common was nausea followed in order of decreasing frequency by abdominal discomfort, vomiting, and diarrhea. To date, antibiotic-associated colitis with Clostridium difficile cytotoxin in the stool has been rare following fluoroquinolone therapy (22,321,672).…”