Cipro (Ciprobay) scientific update |
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Can J Microbiol. 2007 Jan;53(1):144-147.
Adjei MD, Heinze TM, Deck J, Freeman JP, Williams AJ, Sutherland JB
Acetylation and nitrosation of ciprofloxacin by environmental strains of mycobacteria.
Environmental strains of mycobacteria can be determined by Acetylation and nitrosation of ciprofloxacin.
To determine the ability of environmental bacteria to metabolize the frequently prescribed fluoroquinolone drug ciprofloxacin, eight Mycobacterium spp. cultures were grown for 4 days in a medium containing sorbitol and yeast extract with 100 mg.L–1 ciprofloxacin. After the cultures had been centrifuged and the supernatants extracted with ethyl acetate, two metabolites were purified by using high-performance liquid chromatography. They were identified with liquid chromatography/electrospray ionization mass spectrometry and proton nuclear magnetic resonance spectroscopy. Ciprofloxacin was transformed to both N-acetylciprofloxacin (2.5%–5.5% of the total peak area at 280 nm) and N-nitrosociprofloxacin (6.0%–8.0% of the peak area) by Mycobacterium gilvum PYR-GCK and Mycobacterium sp. PYR100 but it was transformed only to N-acetylciprofloxacin by Mycobacterium frederiksbergense FAn9, M. gilvum ATCC 43909, M. gilvum BB1, Mycobacterium smegmatis mc2155, Mycobacterium sp. 7E1B1W, and Mycobacterium sp. RJGII-135. The results suggest that biotransformation may serve as a ciprofloxacin resistance mechanism for these bacteria.
Drug Metab Pharmacokinet. 2007 Apr;22(2):88-95.
Chono S, Tanino T, Seki T, Morimoto K.
Department of Pharmaceutics, Hokkaido Pharmaceutical University.
Pharmacokinetic and pharmacodynamic efficacy of intrapulmonary administration of ciprofloxacin for the treatment of respiratory infections.
The treatment of respiratory infections are based on the Pharmacokinetic and pharmacodynamic efficacy of intrapulmonary administration of ciprofloxacin
The pharmacokinetic and pharmacodynamic efficacy of intrapulmonary administration of ciprofloxacin (CPFX) for the treatment of respiratory infections caused by pathogenic microorganisms resisting sterilization systems of alveolar macrophages (AMs) was evaluated by comparison with an oral administration. The time-courses of the concentration of CPFX in AMs and lung epithelial lining fluid (ELF) following intrapulmonary administration of CPFX solution to rats (200 mug/kg) were markedly higher than that following oral administration (10 mg/kg). The time-course of the concentrations of CPFX in plasma following intrapulmonary administration was markedly lower than that in AMs and ELF. These results indicate that intrapulmonary administration is more effective in delivering CPFX to AMs and ELF, compared with oral administration, in spite of a low dose and it avoids distribution of CPFX to the blood. In addition, the antibacterial effects of CPFX in AMs and ELF following intrapulmonary administration were evaluated by pharmacokinetics/pharmacodynamics analysis. The concentration of CPFX in AMs and ELF-time curve (AUC)/minimum inhibitory concentration of CPFX (MIC) ratio and the maximum concentration of CPFX in AMs and ELF (C(max))/MIC ratio were markedly higher than the effective values. The present study indicates that intrapulmonary administration of CPFX is an effective technique for the treatment of respiratory infections.
J Trace Elem Med Biol. 2007;21(2):132-7.
Zaghloul IY, Radwan MA, Aly ZH.
Department of Clinical Pharmacy, College of Pharmacy, PO Box 22452, Riyadh 11495, Saudi Arabia.
The effect of chronic cadmium exposure on the pharmacokinetics of theophylline and ciprofloxacin in rats.
Efficacy of chronic cadmium exposure on the pharmacokinetics of theophylline and ciprofloxacin in rats.
Cadmium has been associated with a number of adverse health effects but the impact of those effects on the pharmacokinetics of different drugs has not been investigated. Therefore, the pharmacokinetics of theophylline and ciprofloxacin were studied in cadmium-exposed and control rats (72 rats) following i.p. (6.5mg/kg) and p.o. (10mg/kg) administration, respectively. The third-generation offsprings of rats exposed to 100mug/mL of cadmium chloride in drinking water were used in this study. Following 8 weeks of exposure, animals received the drugs as a single dose. Blood samples were withdrawn at different time-points and the plasma concentrations of both drugs were analyzed by HPLC. The pharmacokinetic parameters of theophylline and ciprofloxacin were altered significantly in the cadmium-exposed animals. For theophylline, a statistically significant increase (p<0.0001) in C(max) (69%) and AUC(0-)(infinity) (68%) of theophylline in the cadmium-exposed rats as compared to the control were observed. A corresponding significant (p<0.0001) reduction of 41% in clearance (CL/F) of theophylline was detected in the exposed group. Neither the half-life nor the mean residence time (MRT) showed any significant change due to the exposure to cadmium. For ciprofloxacin, no significant difference was seen in the C(max) of the exposed group as compared to the control animals. However, a delay in T(max) was observed in the exposed group (from 0.16(+/-0.003) to 0.37(+/-0.14)h). A small, but significant increase in t(1/2) (p<0.05) was detected (1.74(+/-0.25) vs. 1.45(+/-0.12)h). A significant reduction (p<0.05) of CL/F from 30.54(+/-1.9) to 24.01(+/-3.81)mL/min/kg was seen in the treated group. The current investigation showed that chronic exposure to cadmium could have a very significant impact on altering the pharmacokinetic parameters of various drugs. Therefore, in cadmium-polluted areas, dose adjustments and drug monitoring, especially for drugs with a narrow therapeutic window, should be carried out.
Infect Control Hosp Epidemiol. 2006 Oct;27(10):1088-95.
Zillich AJ, Sutherland JM, Wilson SJ, Diekema DJ, Ernst EJ, Vaughn TE, Doebbeling BN.
Department of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, Indiana, USA.
Antimicrobial Use Control Measures to Prevent and Control Antimicrobial Resistance in US Hospitals.
Control measures to prevent antimicrobial resistance in US Hospitals.
Objective. Clinical practice guidelines and recommended practices to control use of antibiotics have been published, but the effect of these practices on antimicrobial resistance (AMR) rates in hospitals is unknown. The objective of this study was to examine relationships between antimicrobial use control strategies and AMR rates in a national sample of US hospitals.Design. Cross-sectional, stratified study of a nationally representative sample of US hospitals.Methods. A survey instrument was sent to the person responsible for infection control at a sample of 670 US hospitals. The outcome was current prevalences of 4 epidemiologically important, drug-resistant pathogens, considered concurrently: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, ceftazidime-resistant Klebsiella species, and quinolone (ciprofloxacin)-resistant Escherichia coli. Five independent variables regarding hospital practices were selected from the survey: the extent to which hospitals (1) implement practices recommended in clinical practice guidelines and ensure best practices for antimicrobial use, (2) disseminate information on clinical practice guidelines for antimicrobial use, (3) use antimicrobial-related information technology, (4) use decision support tools, and (5) communicate to prescribers about antimicrobial use. Control variables included the hospitals' number of beds, teaching status, Veterans Affairs status, geographic region, and number of long-term care beds; and the presence of an intensive care unit, a burn unit, or transplant services. A generalized estimating equation modeled all resistance rates simultaneously to identify overall predictors of AMR levels at the facility.Results. Completed survey instruments were returned by 448 hospitals (67%). Four antimicrobial control measures were associated with higher prevalence of AMR. Implementation of recommended practices for antimicrobial use (P<.01) and optimization of the duration of empirical antibiotic prophylaxis (P<.01) were associated with a lower prevalence of AMR. Use of restrictive formularies (P=.05) and dissemination of clinical practice guideline information (P<.01) were associated with higher prevalence of AMR. Number of beds and Veterans Affairs status were also associated with higher AMR rates overall.Conclusions. Implementation of guideline-recommended practices to control antimicrobial use and optimize the duration of empirical therapy appears to help control AMR rates in US hospitals. A longitudinal study would confirm the results of this cross-sectional study. These results highlight the need for systems interventions and reengineering to ensure more-consistent application of guideline-recommended measures for antimicrobial use.
J Infect Chemother. 2005 Feb;11(1):52-4.
Okimoto N, Yamato K, Honda Y, Kurihara T, Osaki K, Asaoka N, Fujita K, Ohba H.
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School Kawasaki Hospital, 2-1-80 Nakasange, Okayama, 700-0821, Japan.
Clinical effect of intravenous ciprofloxacin on hospital-acquired pneumonia.
Efficacy of intravenous ciprofloxacin for the treatment of acquired pneumonia
The effect of intravenous ciprofloxacin (CPFX) on hospital-acquired pneumonia was examined. The subjects were 32 patients with hospital-acquired pneumonia classified as being in group I, group II, and group III, based on The Japanese Respiratory Society Guidelines for management of hospital-acquired pneumonia. None of the patients had received antibiotic treatment for the pneumonia. CPFX 300 mg was intravenously infused twice daily for 3-14 days, and its clinical effect, bacterological effect, and side effects were examined. Intravenous CPEX was clinically effective in 21 of the 32 patients, with an efficacy rate of 65.6%. With regard to bacteriological efficacy, 4 of 5 strains of methicillin-sensitive Staphylococcus aureus, 2 of 3 strains of Klebsiella pneumoniae, 1 of 2 strains of Streptococcus pneumoniae, 1 of 2 strains of Streptococcus agalactiae, 1 of 2 strains of Pseudomonas aeruginosa, 1 of 2 strains of Serratia marcescens, and the 1 strain of Klebsiella oxytoca were eradicated, with an eradication rate of 42.3% (11 of 26 strains whose fate was confirmed eradicated). Abnormal laboratory findings (side effects) were observed in 11 of the 32 patients (34.4%), but all side effects were mild. Based on the above data, intravenous CPFX may be the drug which should be recommended as the first choice for hospital-acquired pneumonia.
J Antimicrob Chemother. 2005 Feb 24; [Epub ahead of print]
Seral C, Barcia-Macay M, Mingeot-Leclercq MP, Tulkens PM, Van Bambeke F.
Unite de pharmacologie cellulaire et moleculaire, Universite catholique de Louvain, Brussels, Belgium.
Comparative activity of quinolones (ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin) against extracellular and intracellular infection by Listeria monocytogenes and Staphylococcus aureus in J774 macrophages.
Effect of quinolones such as ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin, against extracellular and intracellular infection by Listeria monocytogenes and Staphylococcus aureus in J774 macrophages
OBJECTIVES: Quinolones accumulate in eukaryotic cells and show activity against a large array of intracellular organisms, but systematic studies aimed at examining their pharmacodynamic profile against intracellular bacteria are scarce. The present work aims at comparing intracellular-to-extracellular activities in this context. METHODS: We assessed the activities of ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin against the extracellular (broth) and intracellular (infected J774 macrophages) forms of Listeria monocytogenes (cytosolic infection) and Staphylococcus aureus (phagolysosomal infection) using a range of clinically meaningful extracellular concentrations (0.06-4 mg/L). RESULTS: All four quinolones displayed concentration-dependent bactericidal activity against extracellular and intracellular L. monocytogenes and S. aureus for extracellular concentrations in the range 1-4-fold their MIC. Compared at equipotent extracellular concentrations, intracellular activities against L. monocytogenes were roughly equal to those that were extracellular, but were 50-100 times lower against S. aureus. Because quinolones accumulate in cells (ciprofloxacin, approximately 3 times; levofloxacin, approximately 5 times; garenoxacin, approximately 10 times, moxifloxacin, approximately 13 times), these data show that, intracellularly, quinolones are 5-10 times less potent against L. monocytogenes (P=0.065 [ANCOVA]), and at least 100 times less potent (P < 0.0001) against S. aureus. Because of their lower MICs and higher accumulation levels, garenoxacin and moxifloxacin were, however, more active than ciprofloxacin and levofloxacin when compared at similar extracellular concentrations. CONCLUSIONS: Quinolone activity is reduced intracellulary. This suggests that either only a fraction of cell-associated quinolones exert an antibacterial effect, or that intracellular activity is defeated by the local environment, or that intracellular bacteria only poorly respond to the action of quinolones.
J Antimicrob Chemother. 2005 Feb 24; [Epub ahead of print]
Steward J, Piercy T, Lever MS, Nelson M, Simpson AJ, Brooks TJ.
Biomedical Sciences, Dstl Porton Down, Salisbury SP4 OJQ, UK.
Comparison of gatifloxacin, moxifloxacin and ciprofloxacin for treatment of experimental Burkholderia pseudomallei infection.
Treatmant for experimental Burkholderia pseudomallei infection using gatifloxacin, moxifloxacin and ciprofloxacin.
OBJECTIVES: To compare the efficacy of moxifloxacin, gatifloxacin and ciprofloxacin for the post-exposure prophylaxis and treatment of experimental Burkholderia pseudomallei infection. The presence of persistent infection in treated animals and the rate of relapse following dexamethasone treatment were also investigated. METHODS: BALB/c mice were inoculated subcutaneously with 1.75 x 10(6) cfu of B. pseudomallei strain 576. Gatifloxacin, moxifloxacin and ciprofloxacin (100 mg/kg) were given orally at 12 hourly intervals for 14 days starting at 6 h, 7 days or 12 days post-challenge. Control mice did not receive antibiotic therapy. RESULTS: No regimen gave 100% protection. Prophylaxis was most effective when started 6 h post-challenge, with survival rates at 42 days for ciprofloxacin, gatifloxacin and moxifloxacin being 58%, 75% and 75%, respectively. For treatment started at day 7 post-challenge, survival rates were 17%, 11% and 44%, respectively. When antibiotic treatment was delayed until day 12 post-challenge, survival rates fell to 21%, 17% and 28%, respectively. Following dexamethasone treatment of survivors at 42 days post-challenge, relapses occurred in all treatment groups. CONCLUSIONS: Fluoroquinolones do not provide good post-exposure protection against infection with B. pseudomallei. The newer agents moxifloxacin and gatifloxacin are not significantly better than ciprofloxacin for this purpose.
Harefuah 2002 May;141 Spec No:63-72, 121, 120
Mozes YN, Winder A, Tadmor B, Rotman E, Sagi R, Hourvitz A
Childrens Ward A, Schneider Childrens Medical Centre, Israel
Anthrax - an overview at 2002
An overview of Anthrax in 2002.
BACKGROUND: Bacillus anthracis, the causative agent of anthrax, is well known in human history as a major cause of disease in domestic and wild animals and as a rare condition in humans. For the last seventy years, anthrax was developed and occasionally stored as an agent of biological weapon arsenal in numerous countries. The incubation period in humans is 1-6 days and the disease may be present as three distinct clinical syndromes: cutaneous, inhalational, and gastrointestinal disease. The major concern in regard of biological warfare is the inhalational form of anthrax, which starts as a febrile flu-like disease. The development of malaise, fatigue, cough and mild chest discomfort is followed by severe respiratory distress with dyspnea, diaphoresis, stridor, and cyanosis. Shock and death occur within 24-36 hours after onset of severe symptoms. Physical findings are non-specific, but a widened mediastinum is usually seen on chest x-ray. A positive blood culture, immunohistochemical methods and the use of the polymerase chain reaction method confirm the diagnosis. Although effectiveness may be limited after severe symptoms are present, a high dose of antibiotic treatment should be administered and aggressive supportive therapy may be necessary. In the situation of an anthrax attack, as was recently seen in the United States, penicillin is no longer recommended as an acceptable first line therapy. In this case, ciprofloxacin or doxycycline is the recommended drug of choice since penicillin-resistant strains may be used, as well as the possibility of the emergence of an inducible beta-lactamase positive bacterium. Since a high infecting dose may exacerbate the clinical course of the disease, a combination antibiotic regimen should be considered. The disease is not contagious and standard precautions are sufficient. Pre-exposure prophylaxis is based on a vaccine administration, while post-exposure prophylaxis is feasible by the initial use of oral ciprofloxacin or doxycycline. In this article we reviewed the literature with emphasis on the recent medical reports from the United States analyzing the eleven cases of inhalational anthrax as well as the new guidelines for diagnosis and treatment that resulted from the bioterrorism attack in October 2001. Although physical findings were non-specific, abnormal findings on chest x-rays were present in all the eleven cases. A positive blood culture, immunohistochemical methods and the use of the polymerase chain reaction method were highly valuable in revealing and confirming the diagnosis of anthrax. In the case of an attack with anthrax spores, the likelihood of exposure to a large infective dose of high quality spores, may require a prolonged period of treatment as well as prolonged post-exposure therapy.
Nihon Kokyuki Gakkai Zasshi. 2003 Mar;41(3):211-8.
Sasaki E, Kaida H, Izumikawa K, Izumikawa K, Hara K, Hirakata Y, Tomono K, Kohno S.
Department of Internal Medicine, Izumikawa Hospital.
Two cases of Legionella pneumophila pneumonia improved by parenteral ciprofloxacin administration.
Parenteral ciprofloxacin administration for the legionella pneumophila pneumonia saved two patients.
We report here two cases of Legionella pneumophila pneumonia that were markedly improved by parenteral ciprofloxacin administration. A 69-year-old man who had previously visited a hot spring was admitted to our hospital with severe pneumonia and a 48-year-old man with dilated cardiomyopathy as an underlying disease was also hospitalized because of heart failure and pneumonia. In both cases a urinary antigen test for L. pneumophila was negative at the incipient stage, and the initial treatment with a beta-lactam agent was ineffective. However, the high titer of L. pneumophila serogroup 6 antigen in the serum at the convalescent stage revealed that these two pneumonia cases were caused by L. pneumophila, and the following intravenous administration of ciprofloxacin was highly effective. We concluded that intravenous treatment with ciprofloxacin could be effective against L. pneumophila pneumonia, which is sometimes hard to diagnose in the acute phase.
Intern Med. 2003 Apr;42(4):318-21.
Ishikawa T, Okamura S, Oshimoto H, Kobayashi R, Mori M.
First Department of Internal Medicine, Gunma University, Maebashi.
Metronidazole plus ciprofloxacin therapy for active Crohn's disease.
Treatment for Crohn's disease using metronidazole plus ciprofloxacin therapy.
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. RESULTS: Metronidazole plus ciprofloxacin decreased the CRP in seven patients and the IOIBD score 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 CRP and a reduction of the IOIBD score 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.
Scand J Infect Dis. 2003;35(1):34-9.
Ulleryd P, Sandberg T.
Department of Infectious Diseases, Sahlgrenska University Hospital, Goteborg, Sweden.
Ciprofloxacin for 2 or 4 weeks in the treatment of febrile urinary tract infection in men: a randomized trial with a 1 year follow-up.
A randomized trial with a 1 year follow-up on the treatment of febrile urinary tract infection in men using ciprofloxacin for 2 or 4 weeks.
In an open, prospective, single-centre study, 114 men with a presumptive diagnosis of febrile urinary tract infection (UTI) were randomized to oral treatment with ciprofloxacin 500 mg twice daily for 2 or 4 weeks. 72 patients were assessable for efficacy according to the protocol, 65 of whom had prostatic involvement by the infection, as measured by transient increases in serum prostate-specific antigen and prostate volume. All patients responded successfully with resolution of fever and symptoms during treatment. There were no significant differences in short-term bacteriological and clinical cure rates between the 2 treatment regimens [89 vs 97%, 95%, confidence interval (95% CI) for difference in proportions -3 to 19%; and 92 vs 97%, 95% CI -5 to 15%, respectively]. The lower cure rates among those allocated to the 2 week regimen may be explained by a higher frequency of urinary tract abnormalities requiring surgical intervention. After 1 y, 21 patients had experienced recurrences, which comprised asymptomatic bacteriuria (n = 10), symptomatic lower UTI (n = 5) and another episode of febrile UTI (n = 6). The results suggest that a 2 week course of ciprofloxacin may be adequate for febrile UTI in men.
Antibiot Khimioter. 2002;47(10):3-7.
Duisenova AK, Kurmanova KB, Kurmanova GM.
Scientific Center of Hygiene and Epidemiology, Almaty State Institute of Prolonged Education, Republik of Kazakhstan, Almaty.
Ciprofloxacin in the treatment of patients with brucellosis.
Treatment for patients affected with brucellosis using Ciprofloxacin.
With the aim to estimate the clinical and immunological efficiency of the ciprofloxacin (cifloxinal) 105 patients with acute (51), subacute (19) and chronic (35) brucellosis were studied. Control group (17 patients with acute and 30 patients with chronic brucellosis) have been treated with combination of two antibiotics: doxycycline and rifampicin. Ciprofloxacin in a dose 500 mg bid within 14 days in acute stage and 20 days in chronic stage of disease essentially reduced duration of local inflammatory processes of brucellosis with simultaneous treatment of the chronic infection focus, provides good proximate and distant outcomes of treatment. Ciprofloxacin can be considered as an alternative drug for the treatment of brucellosis, more effective (clinically and immunologically) than a combination of two antibiotics: doxycycline and rifampicin.
Int J Oncol. 2003 Apr;22(4):787-94.
Aranha O, Grignon R, Fernandes N, McDonnell TJ, Wood DP Jr, Sarkar FH.
Department of Pathology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA.
Suppression of human prostate cancer cell growth by ciprofloxacin is associated with cell cycle arrest and apoptosis.
Ciprofloxacin can suppress the growth of human prostate cancer cell linked with cell cycle arrest and apoptosis.
For hormone resistant prostate cancer (HRPC), chemotherapy is used but the mortality is 100% with a mean survival time of 7-8 months. Our previous studies have shown the chemotherapeutic effect of ciprofloxacin in bladder cancer. At doses 50-400 micro g/ml ciprofloxacin, the concentrations that are normally achieved at doses currently used for the treatment of anti-bacterial infections, inhibited bladder cancer cell growth and induced S/G2M arrest with modulation of key cell cycle regulatory genes and ultimately activated apoptotic processes. In this study, we investigated the effect of ciprofloxacin on androgen independent prostate carcinoma, PC3 cells and compared our results with non-tumorigenic prostate epithelial cells. The main advantage of this fluroquinolone antibiotic is its relative non-toxicity as compared to current chemotherapy, which is not very effective, for the treatment of advanced hormone resistant prostate cancer. PC3 cells as well as normal prostate epithelial cells (MLC8891) were treated with 25-400 micro g/ml ciprofloxacin, and cell counting was done during 3 days of treatment. The cell death was determined using DAPI staining of cell nuclei, 7AAD-staining followed by flow cytometric analysis as well as by activation of caspase-3, a member of the ICE family of enzymes involved in the apoptotic cascade. The cell lysates were analyzed by immunoblotting techniques for the expression of key genes targeted by ciprofloxacin (p21WAF1, Bax and Bcl-2). Translocation of bax was visualized using a fluorescence staining procedure followed by laser confocal microscopic imaging. Treatment of prostate cancer cells with ciprofloxacin resulted in a dose- and time-dependent inhibition of cell growth (70-100% with 50-400 micro g/ml of the drug). There was a concomitant induction of cell cycle arrest at the S and G2/M phases of the cell cycle as well as induction of apoptosis. The CDK inhibitor p21WAF1 was down-regulated as early as 12 h following ciprofloxacin treatment (100-200 micro g/ml for 12-24 h). There was a significant increase in the Bax/Bcl-2 ratio with translocation of Bax, a pro-apoptotic protein, to mitochondria with concomitant activation of caspase 3. These results suggest the potential usefulness of the fluroquinolone, ciprofloxacin as a chemotherapeutic agent for advanced prostate cancer. The fluroquinolone ciprofloxacin showed anti-proliferative and apoptosis inducing activity on prostate cancer cells but not on non-tumorigenic prostate epithelial cells. These effects of ciprofloxacin were mediated by cell cycle arrest at S-G2/M phase of the cell cycle, Bax translocation to mitochondrial membrane and by increasing the Bax/Bcl-2 ratio in PC3 prostate cancer cells. Based on our in vitro results, further in-depth in vivo animal or human investigations are warranted.
Clin Infect Dis. 2003 Feb 15;36(4):521-3. Epub 2003 Jan 29.
Kuberski T, Robinson L, Schurgin A.
John C. Lincoln Hospital-Deer Valley, Phoenix, AZ, USA.
A case of plague successfully treated with ciprofloxacin and sympathetic blockade for treatment of gangrene.
A successfully treatment of plague with ciprofloxacin and the treatment of gangrene uisng sympathetic blockade.
A critically ill patient with septicemic plague and peripheral gangrene was treated successfully with ciprofloxacin. There are no previous reports of plague being successfully treated with ciprofloxacin. Peripheral gangrene of this patient's feet was managed with use of sympathetic blockade; the patient's toes appear to have been saved by this approach.
Pneumologie. 2002 Oct;56(10):599-604.
Kljucar S, Rost KL, Landen H.
DRK-Kliniken Westend, Zentrale Abteilung fur Anasthesiologie und Intensivmedizin, Berlin, Germany.
Ciprofloxacin in the treatment of hospital-acquired pneumonia: a surveillance study in 676 patients.
A surveillance study in 676 patients on the treatment of hospital-acquired pneumonia using Ciprofloxacin.
BACKGROUND: Controlled clinical trials have shown efficacy of high-dose ciprofloxacin for hospital-acquired (HAP) or nosocomial pneumonia. But it has yet to be demonstrated whether this good efficacy also holds true for routine intensive-care patients outside of controlled trials. PATIENTS: In a post-marketing surveillance study at 87 intensive-care units in Germany we analyzed 676 cases of nosocomial pneumonia treated with intravenous ciprofloxacin in a daily dosage of at least 400 mg. RESULTS: 538 (80 %) patients were evaluable for efficacy. Cure or improvement was reported in 76 % of the cases. Clinical success rate was higher in previously untreated patients receiving ciprofloxacin as monotherapy (85.3 %) or in combination with other antibiotics (78.4 %) than in those who received ciprofloxacin as monotherapy (73.1 %) or as combination therapy (69.2 %) after an antibiotic pretreatment. In the 66 patients with Pseudomonas aeruginosa as causal pathogen, clinical success rate was 86.4 %. 32 adverse events classified as possibly or probably related to ciprofloxacin occurred in 3.1 % of patients; all of those were reversible. CONCLUSIONS: Due to the high success rate, even in cases with failed antimicrobial pretreatment, and the favourable risk-benefit ratio of high-dose ciprofloxacin, ciprofloxacin appears to be an attractive choice in the empiric treatment of hospital-acquired pneumonia.
J Infect Chemother. 2001 Dec;7(4):255-7.
Takahashi S, Hirose T, Satoh T, Kato R, Hisasue SI, Takagi S, Shimizu T, Kunishima Y, Matsukawa M, Itoh N, Tsukamoto T.
Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-8543, Japan.
Efficacy of a 14-day course of oral ciprofloxacin therapy for acute uncomplicated pyelonephritis.
Effect of oral ciprofloxacin therapy, a 14-day course, for the treatment of acute uncomplicated pyelonephritis.
This study aimed to evaluate the efficacy and safety of oral antibacterial treatment with fluoroquinilone for acute uncomplicated pyelonephritis Thirteen female patients with acute uncomplicated pyelonephritis were treated with oral fluoroquinilone (ciprofloxacin; CPFX). They received 200 mg of the drug three times a day while febrile (3-5 days). Once they become afebrile, the same dose of the drug, given twice a day, was given for another 9-11 days. The mean duration of the course of CPFX was 14 days. Symptoms were evaluated, and laboratory examinations, including urine culture and measurement of the minimal inhibitory concentration (MIC) of CPFX were conducted before treatment, and 3, 7, 14, 21, and/or 28 days after the initiation of the treatment. Of the 13 patients, only 5 needed to be hospitalized, and the period of hospitalization was only a few days. On the 14th day after the commencement of treatment, bacteriologic and clinical cure rates were 100%. Escherichia coli was the most common uropathogen, being isolated from the urine of 8 patients. No clinical relapse of the disease was found during a follow-up period of up to 4 weeks. The patients tolerated the drug well without developing any serious adverse effects. Oral antimicrobial chemotherapy with fluoroquinolone, given on an outpatient or short-term hospitalization basis, achieved satisfactory bacteriological and clinical outcomes in the treatment of acute uncomplicated pyelonephritis. This treatment regimen is indicated for patients with this disease who are not in a serious condition with complications such as shock.
Inflamm Bowel Dis. 2001 Nov;7(4):301-5.
Shen B, Achkar JP, Lashner BA, Ormsby AH, Remzi FH, Brzezinski A, Bevins CL, Bambrick ML, Seidner DL, Fazio VW.
Center for Inflammatory Bowel Disease, Department of Gastroenterology, The Cleveland Clinic Foundation, Ohio 44195, USA.
A randomized clinical trial of ciprofloxacin and metronidazole to treat acute pouchitis.
Acute pouchitis can be treated using ciprofloxacin and metronidazole: A randomized clinical trial.
Metronidazole is effective for the treatment of acute pouchitis after ileal pouch-anal anastomosis, but it has not been directly compared with other antibiotics. This randomized clinical trial was designed to compare the effectiveness and side effects of ciprofloxacin and metronidazole for treating acute pouchitis. Acute pouchitis was defined as a score of 7 or higher on the 18-point Pouchitis Disease Activity Index (PDAI) and symptom duration of 4 weeks or less. Sixteen patients were randomized to a 2-week course of ciprofloxacin 1,000 mg/d (n = 7) or metronidazole 20 mg/kg/d (n = 9). Clinical symptoms, endoscopic findings, and histologic features were assessed before and after therapy. Both ciprofloxacin and metronidazole produced a significant reduction in the total PDAI score as well as in the symptom, endoscopy, and histology subscores. Ciprofloxacin lowered the PDAI score from 10.1+/-2.3 to 3.3+/-1.7 (p = 0.0001), whereas metronidazole reduced the PDAI score from 9.7+/-2.3 to 5.8+/-1.7 (p = 0.0002). There was a significantly greater reduction in the ciprofloxacin group than in the metronidazole group in terms of the total PDAI (6.9+/-1.2 versus 3.8+/-1.7; p = 0.002), symptom score (2.4+/-0.9 versus 1.3+/-0.9; p = 0.03), and endoscopic score (3.6+/-1.3 versus 1.9+/-1.5; p = 0.03). None of patients in the ciprofloxacin group experienced adverse effects, whereas three patients in the metronidazole group (33%) developed vomiting, dysgeusia, or transient peripheral neuropathy. Both ciprofloxacin and metronidazole are effective in treating acute pouchitis with significant reduction of the PDAI scores. Ciprofloxacin produces a greater reduction in the PDAI and a greater improvement in symptom and endoscopy scores, and is better tolerated than metronidazole. Ciprofloxacin should be considered as one of the first-line therapies for acute pouchitis.
Cipro (Ciprobay) description...
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Drug category:Antibacterial and antiviral agent
 Cipro (Ciprobay) scientific update
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