Administration Of Ciprofloxacin Research Articles

Negative effect of non-steroidal anti-inflammatory drugs on the antibacterial activity of ciprofloxacin - an in vitro study

Ciprofloxacin, a second generation fluoroquinolone is often co-administered with non-steroidal anti-inflammatory drugs (NSAIDs) in life threatening situations in which Staphylococcus aureus infections are accompanied with pain and inflammation. This study was carried out to investigate possible in vitro interactions in co -administration of ciprofloxacin and some NSAIDs. The study was carried out in the Department of Pharmaceutical Microbiology, Faculty of Pharmacy, and University of Benin, Benin City in 2013. The in vitro evaluation was carried out by incorporating appropriate concentrations of the NSAIDs with ciprofloxacin in 20 ml final volume of Muller Hinton broth in the presence of Staphylococcus aureus and incubated at 37°C in a hot water-bath. Aliquots of 0.1 ml were removed every two hours; serially diluted and plated out on Mannitol Salt agar and incubated at 37oC for 24 hours. The number of colony-forming units (CFU) of Staphylococcus aureus was noted. It was observed that all the NSAIDs reduced the antibacterial activity of ciprofloxacin against Staphylococcus aureus in vitro to varying degrees. The highest reduction was exhibited by acetyl salicylic acid (ASA) as it yielded the highest number of CFU. This was followed closely by piroxicam, then indomethacin and lastly paracetamol (130 cfu; 65 cfu; 43 cfu; and 33 cfu.) respectively. There is a suggestion that the studied NSAIDs and perhaps NSAIDs generally should not be co-administered with ciprofloxacin at the same time. Keywords: Ciprofloxacin; NSAIDs; Interaction

Melatonin can attenuate ciprofloxacin induced nephrotoxicity: Involvement of nitric oxide and TNF-α.

Ciprofloxacin is a synthetic broad-spectrum antimicrobial agent of fluoroquinolone family. The aim of our investigation was to evaluate the role of oxidative damage and inflammation in nephrotoxic potential of Ciprofloxacin and protective effects of melatonin against its nephrotoxicity in male Wistar rats. The animals were divided into six groups: Control, ciprofloxacin (100mg/kg/day, i.p), ciprofloxacin with three doses (2.5, 5 and 10mg/kg/day) of melatonin and a group which received ciprofloxacin (100mg/kg/day) plus vitamin E (100mg/kg/day) for 8 consecutive days. 24h after last injection, the animals were euthanized and kidney tissues were separated. Finally reactive oxygen species, glutathione content, lipid peroxidation, protein carbonyl, nitric oxide and TNF-α were evaluated. Also, pathological examination and measuring of kidney biochemical markers (BUN and Cr) were done. The administration of ciprofloxacin for 8days resulted in significant increase (P<0.01) in kidney biomarkers (BUN and Cr) and pathological changes. Also, Oxidative stress was evident in ciprofloxacin group by significantly (p<0.001) increased reactive oxygen species, lipid peroxidation and protein carbonyl level and decreased glutathione content (p<0.001). Increased in inflammation process was shown by increase in NO and TNF-α (P<0.001). Administration of melatonin was able to protect against deterioration in nephrotoxic markers and suppressed the increase in oxidative stress and inflammatory markers. Our study showed the critical role of oxidative damage and inflammation in ciprofloxacin-induced nephrotoxicity that markedly inhibited by administration of melatonin. So, melatonin can be suggested for prevention of ciprofloxacin-induced nephrotoxicity.

Therapeutic effects of ciprofloxacin/bushenhuazhuo combination on chronic prostatitis

Purpose: To evaluate the clinical effect of bushenhuazhuo (a Chinese traditional medicine) in combination with ciprofloxacin (an orthodox medicine) in chronic prostatitis (CP) therapy.Methods: A total of 160 patients who suffered from CP and received treatment in the People’s Hospital of Zhengzhou between April 2012 and June 2014 were selected and divided randomly into treatment and control groups, with 80 patients in each group. Control group was given 0.25 g ciprofloxacin hydrochloride tablets twice a day for 4 weeks. In addition to ciprofloxacin administration, patients in the treatment group also received a dose of bushenhuazhuo preparation twice daily for 4 weeks. Clinical outcomes, quality of life as well as lecithin body and white blood cell (WBC) count in expressed prostatic secretions (EPS-WBC) were evaluated.Results: Cure rates in the treatment and control groups were 90 and 72.50 %, respectively; this difference was significant (p &lt; 0.05). Scores for National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), WBC, and lecithin bodies in the treatment group (8.20 ± 2.20 points, 4.50 ± 1.20 points, and 28.10 ± 2.10 points, respectively) were higher (p &lt; 0.05) than for the control group (12.20 ± 2.20, 6.30 ± 2.20, and 23.30 ± 2.90 points, respectively). The levels of interferon (IFN)-γ and tumour necrosis factor (TNF)-α in the treatment group (26.20 ± 3.30 and 33.80 ± 5.40 mg/L, respectively) were lower than those in the control group (37.70 ± 3.90 and 48.40 ± 3.70 mg/L, respectively), whereas the level of interleukin (IL)-10 in the treatment group (292.60 ± 23.70 mg/L) was higher (p &lt; 0.05) than that in control group (235.80 ± 25.90 mg/L).Conclusion: Ciprofloxacin combined with the Chinese traditional medicine, bushenhuazhuo preparation, demonstrates a marked therapeutic effect in CP. Its mechanism of action may be related to decreased levels of IFN-γ and TNF-α and increased IL-10.Keywords: Bushenhuazhuo, Interferon – γ, Ciprofloxacin, Chronic prostatitis symptom index

Amoxicillin-clavulanic acid and ciprofloxacin-treated SPF mice as gnotobiotic model

The experiment was carried out on 24 SPF BALB/c female mice and lasted for 15days with a 5-day antibiotic (ATB) treatment and then 10days without ATB treatment. The aim of our study was to acquire an animal model with reduced and controlled microflora and, at the same time, to ensure that the good health of these animals is maintained. Per oral administration of amoxicillin and clavulanate potassium in Amoksiklav (Sandoz, Slovenia) at a dose of 387.11mg/kg body weight (0.2ml of dilution per mouse) and subcutaneous administration of ciprofloxacin in Ciloxan (Alcon, Spain) at a dose of 18.87mg/kg body weight (0.1ml of dilution per mouse) were performed every 12h during first 5days of experiment. Five-day treatment with ATB led to a reduced survivability of microorganisms in faeces (28.33±0.43% on day 2) and caecum content (28.10±1.56%), where no cultivable microorganisms in faeces were present. Ten-day convalescence of decontaminated animals under gnotobiotic conditions prevented recovery of species diversity in mice gut microflora. This was reduced to two detectable cultivable species, namely Escherichia coli (GenBank KX086704) and Enterococcus sp. (GenBank KX086705) which were capable to restore its metabolic (CRL 2012) and morphological potential (Baratta et al. Histochem Cell Biol 131:713-726, 2009) within physiological range. Animals obtained under this procedure can be used in further studies. As a result, we created a mouse gnoto model with reduced and controlled microflora without alteration of the overall health status of the respective animals.

Inhibitory Effects of Multiple-Dose Treatment with Baicalein on the Pharmacokinetics of Ciprofloxacin in Rats.

Ciprofloxacin is used as a treatment for urinary and respiratory tract infections in clinical practice. Baicalein, a major flavonoid present in Scutellaria baicalensis, is a well-known and potent antibacterial compound used in complementary and alternative medicine practices. The present study aimed to clarify the effects of multiple-dose treatment with baicalein on the pharmacokinetics of ciprofloxacin in rats. Following the oral administration of baicalein (20, 40, or 80 mg/kg) for five consecutive days, the rats received an oral administration of ciprofloxacin (20 mg/kg). Blood samples were collected at specific time points, and the plasma concentrations of ciprofloxacin were determined by using high-performance liquid chromatography. To evaluate the mechanisms underlying the interaction between baicalein and ciprofloxacin, a rhodamine 123 accumulation assay was performed in LS-180 cells. A pharmacokinetic study revealed that multiple-dose treatment with baicalein significantly decreased the peak serum concentration (Cmax ), area under the curve (AUC0 → 480 min ), and relative bioavailability (Frel ) of ciprofloxacin (p < 0.05). The rhodamine 123 accumulation assay revealed that treatment with baicalein for 48 h markedly reduced the intracellular accumulation of rhodamine 123. Taken together, these findings suggest that baicalein may result in the therapeutic failure of ciprofloxacin or other quinolone-based antibiotics used for chemotherapy in clinical practice. Copyright © 2016 John Wiley & Sons, Ltd.

Nephropathy Evolving Within the First Two Posttransplant Months With No Typical Cytopathic Lesions: Two Cases Presentation

BackgroundWe report 2 cases of polyomavirus-associated nephropathy (PyVAN) emerging within the initial 8 posttransplant weeks. These cases were characterized by intraepithelial BK virus replication without typical nuclear inclusions in epithelial cells. Methods and ResultsA 70-year-old male recipient of a cadaveric kidney transplant had experienced unsatisfying graft function since the time of transplantation (Tx). One month after Tx, results of a graft biopsy revealed mild tubulointerstitial inflammation. No intraepithelial nuclear inclusions suggestive of viral infection were present at that time. The patient received intravenous methylprednisolone, and the dosage of tacrolimus was increased. Due to a further drop in the glomerular filtration rate, a subsequent kidney biopsy was performed during posttransplant week 10, which revealed lesions typical of PyVAN. Retrospectively performed SV40 staining revealed that intragraft polyomavirus replication was already present on posttransplant day 30. Basic immunosuppression reduction and ciprofloxacin administration were followed by BK viremia elimination, stabilization of graft function, and resolution of PyVAN. In another patient, a 62-year-old male recipient of a cadaveric renal graft, BK viremia was monitored from the time of Tx. Two months after Tx, the patient was found to have a BK viral load of 6 × 4 log10/mL. Results of the graft biopsy revealed fully preserved tubular epithelium, but SV40 staining was positive in some of these cells. After basic immunosuppression reduction and introduction of ciprofloxacin, the BK viral load dropped to 1 × log10/mL with graft function stabilization. ConclusionsPyVAN may emerge as early as 4 weeks after Tx, with near-normal or acute rejection–like graft morphology. The early monitoring of plasma BK viral load, as well as SV40 staining, avoids misdiagnosis of this severe posttransplant complication.

Ciprofloxacin-Induced ANCA-Negative Vasculitis with Cutaneous and Gastrointestinal Involvement: A Case-Based Review of the Literature

Summary A 71-year-old woman presented with constitutional signs and lower extremity palpable purpura after being prescribed a four-day course of 500 mg of ciprofloxacin two times daily for a gastrointestinal infection. She was admitted for inpatient treatment. During the third hospital day she presented with an episode of abundant hematemesis while her skin lesions remained unchanged. Upper endoscopy revealed multiple lesions consistent with vasculitis and histological examination of the skin biopsy disclosed a leucocytoclastic vasculitis. The patient was successfully treated with prednisone following ciprofloxacin discontinuation. Complete resolution of the lesions on drug withdrawal strongly suggested drug toxicity and pressed us to use the Naranjo adverse drug reaction probability scale to confirm the diagnosis. Awareness that the development of skin and gastrointestinal lesions following administration of ciprofloxacin may be a manifestation of ciprofloxacin-induced vasculitis,

Weakness of the extremities in a 73-year-old male patient

A patient undergoing cyclosporine therapy presented with muscle weakness. This was preceded by diarrhea and treated with ciprofloxacin. Rhabdomyolysis was diagnosed clinically and biochemically. This was presumably drug-induced triggered by a combined therapy with cyclosporine, amlodipine, simvastatin and ciprofloxacin. The case presented demonstrates that during therapy with several substances which inhibit the degradation of simvastatin, the additional administration of ciprofloxacin should be considered with extreme caution.

Septic abortion caused by Campylobacter jejuni bacteraemia

A 20-year-old female patient, 14 weeks pregnant, was admitted to hospital with anamnestic and clinical features of acute pyelonephritis. Clinical signs of septic abortion developed and after obstetric examination the therapy was changed to ampicillin, gentamicin and clindamycin. Campylobacter jejuni was isolated from blood cultures. Pathohistological findings confirmed diagnosis of purulent chorioamnionitis. After 2 weeks of ciprofloxacin administration the patient fully recovered. Campylobacter jejuni was not isolated from stool culture and no signs of acute enteritis were registered during the illness. Invasive forms of Campylobacter disease without enteritis are not unusual in immunocompromised hosts but they are restricted to C. fetus rather than C. jejuni isolates.

Increased Tacrolimus Levels After Administration of Ciprofloxacin to a Patient with Renal Transplant

Tacrolimus is a calcineurin inhibitor that is used to prevent organ rejection following renal transplant. The tacrolimus dose is adjusted based on clinical response and blood concentrations because patient to patient variability exists in both pharmacokinetics and pharmacodynamics. Fluoroquinolones are frequently used for treatment due of their broad spectrum of activity; however, some are reported to increase the blood concentration of calcineurin inhibitors. In this study, we describe a patient who had undergone a renal transplant and experienced a clinically significant interaction between tacrolimus and ciprofloxacin. In this case, the patient required a very low dose of tacrolimus (1 mg/day) to achieve target blood levels. This was probably due to pharmacokinetic diversity related to the CYP3A enzymatic system and high blood levels after ciprofloxacin use. The blood levels of tacrolimus increased after the use of ciprofloxacin and returned to baseline once the drug was discontinued. Health care professionals should be aware of such drug interactions.

A Case of Fluoroquinolone-Resistant Leprosy Discovered after 9 Years of Misdiagnosis.

We report a case of misdiagnosed leprosy in a 21-year-old Malagasy male, who, improperly treated, developed secondary mycobacterial resistance to fluoroquinolone. The patient contracted the infection 9 years prior to the current consultation, displaying on the right thigh a single papulonodular lesion, which progressively spread to the lower leg, back, and face. Initial administration of ciprofloxacin and prednisolone led to temporary and fluctuating improvement. Subsequent long-term self-medication with ciprofloxacin and corticosteroid did not heal the foul and nonhealing ulcers on the legs and under the right sole. Histopathological findings were compatible with lepromatous leprosy. Skin biopsy was positive for acid-fast bacilli and PCR assay confirmed the presence of a fluoroquinolone-resistant strain of Mycobacterium leprae (gyrA A91V). After 6 months of standard regimen with rifampicin, clofazimine, and dapsone, clinical outcome significantly improved. Clinical characteristics and possible epidemiological implications are discussed.

Ciprofloxacin Therapy Results in Mitigation of ATP Loss after Irradiation Combined with Wound Trauma: Preservation of Pyruvate Dehydrogenase and Inhibition of Pyruvate Dehydrogenase Kinase 1.

Ionizing radiation exposure combined with wound injury increases animal mortalities than ionizing radiation exposure alone. Ciprofloxacin (CIP) is in the fluroquinolone family of synthetic antibiotic that are available from the strategic national stockpile for emergency use and is known to inhibit bacterial sepsis. The purpose of this study was to evaluate the efficacy of ciprofloxacin as a countermeasure to combined injury mortality and determine the signaling proteins involved in energy machinery. B6D2F1/J female mice were randomly assigned to receive either 9.75 Gy irradiation with Co-60 gamma rays followed by skin wounding (combined injury; CI) or sham procedure (sham). Either ciprofloxacin (90 mg/kg/day) or vehicle (VEH) (water) was administered orally to these mice 2 h after wounding and thereafter daily for 10 days. Determination of tissue adenosine triphosphate (ATP) was conducted, and immunoblotting for signaling proteins involved in ATP machinery was performed. Combined injury resulted in 60% survival after 10 days compared to 100% survival in the sham group. Furthermore, combined injury caused significant reductions of ATP concentrations in ileum, pancreas, brain, spleen, kidney and lung (-25% to -95%) compared to the sham group. Ciprofloxacin administration after combined injury resulted in 100% survival and inhibited reductions in ileum and kidney ATP production. Ileum protein levels of heat-shock protein 70 kDa (HSP-70, a chaperone protein involved in ATP synthesis) and pyruvate dehydrogenase (PDH, an enzyme complex crucial to conversion of pyruvate to acetyl CoA for entrance into TCA cycle) were significantly lower in the CI group (vs. sham group). Using immunoprecipitation and immunoblotting, HSP-70-PDH complex was found to be present in the ileum tissue of CI mice treated with ciprofloxacin. Furthermore, phosphorylation of serine residues of PDH resulting in inactivating PDH enzymatic activity, which occurred after combined injury, was inhibited with ciprofloxacin treatment, thus enabling PDH to increase ATP production. Increased ileum levels of pyruvate dehydrogenase kinase 1 protein (PDK1, an enzyme responsible for PDH phosphorylation) after combined injury were also prevented by ciprofloxacin treatment. Taken together, these data suggest that ciprofloxacin oral administration after combined injury had a role in sustained ileum ATP levels, and may have acted through preservation of PDH by HSP-70 and inhibition of PDK1. These molecular changes in the ileum are simply one of a host of mechanisms working in concert with one another by which ciprofloxacin treatment mitigates body weight loss and drastically enhances subsequent survival after combined injury. To this end, our findings indicate that oral treatment of ciprofloxacin is a valuable therapeutic treatment after irradiation with combined injury and warrants further analyses to elucidate the precise mechanisms involved.

Impact of Ciprofloxacin and Clindamycin Administration on Gram-Negative Bacteria Isolated from Healthy Volunteers and Characterization of the Resistance Genes They Harbor.

The aim of this study was to assess the impact of ciprofloxacin, clindamycin, and placebo administration on culturable Gram-negative isolates and the antibiotic resistance genes they harbor. Saliva and fecal samples were collected from healthy human volunteers before and at intervals, up to 1 year after antibiotic administration. Samples were plated on selective and nonselective media to monitor changes in different colony types or bacterial species. Following ciprofloxacin administration, there was a decrease of Escherichia coli in feces and after clindamycin administration a decrease of Bacteroides in feces and Leptotrichia in saliva, which all returned to pretreatment levels within 1 to 4 months. Ciprofloxacin administration also resulted in an increase in ciprofloxacin-resistant Veillonella in saliva, which persisted for 12 months. Additionally, 949 aerobic and anaerobic isolates purified from ciprofloxacin- and clindamycin-containing plates were screened for the presence of resistance genes. Resistance gene carriage was widespread in isolates from all three treatment groups, and no association was observed between genes and antibiotic administration. Although the anaerobic component of the microbiota was not a major reservoir of aerobe-associated antimicrobial resistance (AMR) genes, we detected the sulfonamide resistance gene sul2 in anaerobic isolates. The longitudinal nature of the study allowed identification of distinct Escherichia coli clones harboring multiple resistance genes, including one carrying an extended-spectrum β-lactamase blaCTX-M group 9 gene, which persisted in the gut for up to 4 months. This study provided insight into the effects of antibiotic administration on healthy microbiota and the diversity of resistance genes harbored therein.

Ciprofloxacin-induced neurotoxicity: evaluation of possible underlying mechanisms

Ciprofloxacin (CPX) is a fluoroquinolone antibiotic used for treating respiratory, urinary tract, gastrointestinal and abdominal infections. There are only a limited number of studies related to neurological adverse effects of this drug in therapeutic doses. Therefore, in the present study, we aimed to investigate the influence of CPX, when administered at pharmacological doses, on behavioral parameters of rats and the probable underlying mechanisms. CPX was administered in single oral daily doses of 20 and 50 mg/kg for 14 days in rats. CPX-induced depression and anxiety were evaluated by modified forced swimming test and elevated plus maze test, respectively. Also, spontaneous locomotor activity and motor coordination were assessed by activity cage and Rota-rod apparatus. Effects of CPX administration on brain serotonin, dopamine, γ-amino-butyric acid (GABA), glutamate, adrenaline and noradrenaline levels were determined by high performance liquid chromatography (HPLC) analysis. Contribution of oxidative stress to the changes induced by CPX administration was evaluated by measuring brain catalase, superoxide dismutase, glutathione (GSH) and malondialdehyde (MDA) levels. Our results indicated that depression-like and anxiety-like behaviors were observed only in the 50 mg/kg CPX-administered group with simultaneous decreases in the brain serotonin and GABA levels. In addition, in the brain homogenates of CPX-administered groups, increased MDA as well as decreased GSH and catalase activity with respect to their controls, indicated enhanced oxidative stress and weakened antioxidant defense system. In conclusion, repeated pharmacological doses of CPX were found to induce neurological toxicity. Also, altered brain neurotransmitter levels and increased oxidative stress observed in our study were thought to be the possible underlying mechanisms of ciprofloxacin-induced neurotoxicity.

Comparison between ciprofloxacin and trimethoprim-sulfamethoxazole in antibiotic prophylaxis for transrectal prostate biopsy.

The aim of this study was to compare the efficacies of oral ciprofloxacin administration and oral trimethoprim-sulfamethoxazole (TMP-SMX) regimens in preventing infectious complications following transrectal ultrasound guided biopsy of the prostate. Between 2011-2013, the medical records of 391 (mean age 64.62±7.64 years; range 40 to 87 years) patients who underwent transrectal prostate biopsies, due to suspicion of prostate cancer were retrospectively reviewed. While 500 mg ciprofloxacin was given orally twice daily starting one day before the procedure, continued for 3 days in the first 174 patients (group 1); was given orally twice daily starting one day before the procedure, continued for 3 days in the remaining 217 patients (group 2) for prophylaxis. Urine samples were obtained for urine culture before the procedure. The two groups were compared with respect to findings of urine cultures performed before and after the procedure and complications. In the ciprofloxacin and groups, any positive urine culture before the procedure was not observed. Complications occured in 93 patients (37 in group 1 and 56 in group 2), after the procedure. Twenty-two (5.6%) (11 in group 1 and 11 in group 2). patients were admitted to our clinic because of high fever occurring after biopsy. Nine ciprofloxacin-treated (5.2%) and 16 TMP-SMX-treated (7.4%) patients had severe dysuria after the procedure. Twenty-one ciprofloxacin recipients (12.1%) and 40 TMP-SMX recipients (18.4%) had macroscopic hematuria. In the ciprofloxacin and TMP-SMX groups, the incidences of new culture positivity were 4% (n=7) and 2.8% (n=6) after the procedure, respectively. All of the isolated bacteria was Escherichia coli. While 11 patients were hospitalized due to signs of complicated urinary tract infections, and 2 patients were treated as outpatients. Rectal bleeding that did not require any intervention was observed in a patient 8 hours after biopsy. SIRS findings were detected in two patients. There were no significant differences between the two groups with respect to age, prostate volume, prostate spesific antigen (PSA) levels, and results of urine culture performed after the procedure (p>0.05). Despite the increasing resistance to antibiotics, ciprofloxacin and TMP-SMX are effective prophylactic treatment modalities for transrectal prostate biopsy. Both three-day ciprofloxacin and TMP-SMX regimens seem to be equally effective in the antibiotic prophylaxis for transrectal prostate biopsy.

Multiparametric MR Imaging Depicts Glycosaminoglycan Change in the Achilles Tendon during Ciprofloxacin Administration in Healthy Men: Initial Observation.

To determine if quantitative magnetic resonance (MR) imaging techniques (sodium MR imaging, glycosaminoglycan [GAG] chemical exchange saturation transfer [CEST], and T2* mapping) could be used as potential markers for biochemical changes in the Achilles tendon induced by ciprofloxacin intake. The ethics committee of the Medical University of Vienna approved the protocol (number 1225/2012), and all patients gave written informed consent. Fourteen ankles from seven men (mean age, 32 years ± 12 [standard deviation]) were included in the study. All patients underwent 7-T MR imaging examinations of the Achilles tendon at baseline and 10 days and 5 months after ciprofloxacin intake. Sodium signal and T2* maps were acquired with the variable echo-time sequence and the GAG CEST values were acquired with a three-dimensional radiofrequency spoiled gradient-recalled-echo sequence. The mean sodium signal was significantly decreased by 25% in the whole tendon (from baseline to 10 days after ciprofloxacin intake, 130 arbitrary units [au] ± 8 to 98 au ± 5, respectively; P = .023) and returned to baseline after 5 months (116 au ± 10), as observed also at the tendon insertion (baseline, 10 days after ciprofloxacin intake, and 5 months after ciprofloxacin intake, 134 au ± 8, 105 au ± 5, and 119 au ± 9, respectively; P = .034). The mean GAG CEST value in the whole tendon was parallel to the sodium signal with a decrease from baseline to 10 days after ciprofloxacin intake, 4.74% ± 0.75 to 4.50% ± 0.23, respectively (P = .028) and an increase at 5 months after ciprofloxacin intake to 4.88% ± 1.02. In conclusion, this study demonstrates a ciprofloxacin-induced reversible reduction of the normalized sodium MR imaging signal and the GAG CEST effect in the Achilles tendon of healthy volunteers. Changes in sodium MR imaging and GAG CEST in men may reflect a decrease of GAG content in the Achilles tendon after ciprofloxacin intake.

Microbiological Aspects of Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis: A Monocentric Five Years Follow up Study

Peritonitis is a serious complication of continuous ambulatory peritoneal dialysis (CAPD). CAPD peritonitis usually occurs due to contamination by bacteria from the skin or the environment of the inserted catheter. The aim of this study was to analyze data about microbial cause of peritonitis in patients on CAPD monitored at University Clinical Centre of Republic of Srpska, Bosnia and Herzegovina in five years period, from October 2010 till October 2015. In the five-year period 69 samples of peritoneal dialysate were examined. The most common isolates were Gram +ve bacteria: Staphylococcus aureus in 9 cases (32.1%), coagulase-negative Staphylococcus 5 (17.6%) and the Gram -ve bacteria Escherichia coli 4 (14.2%) and Enterobacter 3 (10.7%). In one case Candida spp. (3.6%) was isolated. All the Gram positive isolates were sensitive to ciprofloxacin and vancomicin. Among Staphylococcus spp. there were no methicillin resistant strains. The findings of culture of peritoneal dialysate is important for the proper choice of antimicrobial therapy. The use of systemic vancomycin and ciprofloxacin administration is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis.

Pharmacokinetic peculiarities of intravenous and oral ciprofloxacin administration in preoperative prophylaxis in patients with benign prostatic hyperplasia

The study of population pharmacokinetics of ciprofloxacin at various ways of administration helps to found that the once usage of 500 mg ciprofloxacin orally 90-120 min before the surgery as preoperative antibiotic prophylaxis with transurethral resection of the prostate gland creates a significantly higher concentration of the drug in blood, urine and prostate parenchyma compared to intravenously administration of 400 mg ciprofloxacin 30-60 min before operation. Thus, the data obtained explain the higher efficacy of oral administration of ciprofloxacin as preoperative antibiotic prophylaxis in patients undergoing transurethral resection of the prostate.

Clinical and treatment-related risk factors for nosocomial colonisation with extensively drug-resistant Pseudomonas aeruginosa in a haematological patient population: a matched case control study.

BackgroundThis study aimed to investigate risk factors for colonisation with extensively drug-resistant P. aeruginosa (XDR-PA) in immunocompromised patients and to build a clinical risk score (CRS) based on these results.MethodsWe conducted a matched case–control study with 31 cases and 93 controls (1:3). Cases were colonised with XDR-PA during hospitalisation. Independent risk factors were determined using a three step conditional logistic regression procedure. A CRS was built with respect to the corresponding risk fraction of each risk factor, and its discriminatory power was estimated by receiver operating characteristic (ROC) analysis.ResultsThe presence of a central venous catheter (OR 7.41, P = 0.0008), the presence of a urinary catheter (OR 21.04, P < 0.0001), CRP > 10 mg/dl (OR 7.36, P = 0.0015), and ciprofloxacin administration (OR 5.53, P = 0.025) were independent risk factors. The CRS exhibited a high discriminatory power, defining a high risk population with an approximately fourteen times greater risk for XDR-PA colonisation.ConclusionsUnnecessary use of antibiotics, particularly ciprofloxacin should be avoided, and a high standard of infection control measures must be achieved when using medical devices. A CRS can be used for adaptation of the active screening culture policy to the local setting.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0650-9) contains supplementary material, which is available to authorized users.

Development of antimicrobial resistance in the normal anaerobic microbiota during one year after administration of clindamycin or ciprofloxacin

Thirty healthy subjects (15 males and 15 females) were randomly assigned in three groups and clindamycin (150 mg qid) or ciprofloxacin (500 mg bid) or placebo was given for a 10-day period. Skin, nasal, saliva, faeces samples were collected at day – 1, day 11, 1 month, 2 months, 4 months and 12 months post administration for microbiological analysis. Ciprofloxacin or clindamycin had no impact on the anaerobic skin microbiota and the proportions of antibiotic resistant anaerobic bacteria were similar as in the placebo group. Ciprofloxacin had impact on the Propionibacterium acnes in the nasal microbiota that normalized after 1 month, however, ciprofloxacin-resistant P. acnes strains increased at month 2 and month 12. Clindamycin had no impact on the nasal microbiota. In the oropharyngeal microbiota, a higher proportion of ciprofloxacin resistant Veillonella was found, it lasting up to 12 months post dosing. In the clindamycin group, clindamycin-resistant Prevotella spp. were found in increased proportions compared to placebo at various time points except month 4 in the saliva samples. The relative proportion of ciprofloxacin-resistant Bifidobacteria increased in the faecal samples on day 11, 1 month, 4 months and 12 months post dosing compared to placebo. The proportion of clindamycin-resistant Bacteroides spp. increased at 1, 2, 4 and 12 months post dosing compared to placebo in the faecal samples. No Clostridium difficile was recovered from any of the samples from any of the volunteers at any visit. The concentrations of ciprofloxacin or clindamycin in the faeces were higher than the MICs for most of the organisms present in the normal microbiota. No obvious correlation between the groups in resistant patterns for anaerobic bacteria was observed. In conclusion, based on the microbiological data of the microbiota as well as the results of the bioassays for ciprofloxacin and clindamycin concentrations in the faecal samples, oral administration of ciprofloxacin and clindamycin has an impact on the anaerobic microbiota and may have a long-term effect on the development and persistence of antibiotic-resistant anaerobes in the normal microbiota.