Administration Of Ciprofloxacin Research Articles

Safety Assessment of Ciprofloxacin and Roxithromycin through Haematological and Biochemical Profiling in Poultry

The concurrent therapeutic application of ciprofloxacin and roxithromycin has been suggested as a potential approach for addressing mixed bacterial infections in poultry. The present investigation aimed to determine the hematological and biochemical safety profile of concurrently administered ciprofloxacin and roxithromycin through the oral route in poultry. This study involved a total of sixteen birds, which were divided into two equal but random groups of broiler chickens. In the first group, roxithromycin alone was administered orally for five days. Conversely, the Group II birds received repeated concurrent doses of roxithromycin and ciprofloxacin for consecutive five days adhering to their recommended therapeutic dosages. In both groups, blood samples were collected at various intervals, including before drug administration (0 days), and at 6 hours, 12 hours, 1st day, 2nd day, 3rd day, 4th day, 5th day, 7th day, and 10th day. Following haematological and biochemical analyses, a two-way statistical analysis (p ≤ 0.05) was conducted utilizing unpaired ‘t-tests’ to compare parameters within the group across various time points and between Groups I and II. The analysis revealed statistically significant differences in haematological parameters such as heterophils, lymphocytes and monocytes, along with one biochemical parameter, specifically aspartate transaminase. Notably, the altered values primarily remained within the normal range and were often attributed to age-related changes, with certain fluctuations being of a temporary nature and reverting to normal levels by the 10th Day. The study findings support the conclusion that the concurrent oral administration of roxithromycin and ciprofloxacin appears to be safe for therapeutic use in poultry.

Combination MEG3 lncRNA and Ciprofloxacin dramatically decreases cell migration and viability as well as induces apoptosis in GC cells in vitro.

Gastric cancer (GC) is a prominent cause of cancer-related mortality worldwide. Long noncoding RNA (lncRNA) maternal expression gene3 (MEG3) participates in numerous signaling pathways by targeting the miRNA-mRNA axis. Studies on human tumors have demonstrated that the antibiotic Ciprofloxacin induces cell cycle changes, programmed cell death, and growth suppression. In this study, we transfected MEG3 lncRNA and Ciprofloxacin into the MKN-45 GC cell line. qRT-PCR was employed to evaluate the effects on the specific microRNA and mRNA. The wound healing test, MTT assay, and flow cytometry were used to assess the impact of their administration on cell migration, viability, and apoptosis, respectively. Research showed that miR-147 expression fell even more after MEG3 lncRNA transfection, leading to an increase in B-cell lymphoma 2 (BCL-2) levels. Ciprofloxacin transfection did not significantly affect the axis, except for MEG3, which led to its slight upregulation. MEG3 lncRNA inhibited the migration of MKN-45 cells compared to the control group. When MEG3 lncRNA was coupled with Ciprofloxacin, there was a significant reduction in cell migration compared to untreated groups and controls. MTT assay and flow cytometry demonstrated that MEG3 lncRNA decreased cell viability and triggered apoptosis. Simultaneous administration of MEG3 lncRNA and Ciprofloxacin revealed a significant reduction in cell viability caused by increased apoptosis obtained from MTT or flow cytometry assays. Modulating the miR-147-BCL-2 axis decreases cell migration and survival while promoting cell death. In conclusion, combining MEG3 lncRNA with Ciprofloxacin may be an effective therapeutic approach for GC treatment by influencing the miR-14-BCl-2 axis, resulting in reduced cell viability, migration, and increased apoptosis.

Characterization of Antibiotic Treatment among Children Aged 0-59 Months Hospitalized for Acute Bacterial Gastroenteritis in Israel.

We examined the extent and correlates of appropriate antibiotic use among children hospitalized with bacterial acute gastroenteritis (AGE) in Israel, a high-income country setting. Data were collected from children aged 0-59 months who participated in active hospital-based surveillance of AGE undertaken during 2007-2015. Bacterial AGE was defined as having a positive stool culture for Salmonella, Shigella, Campylobacter, or dysentery. Appropriate antibiotic use was defined as the administration of ciprofloxacin, azithromycin, or third-generation cephalosporins during hospitalization or at discharge. Overall, 550 children had bacterial AGE; of those, 369 (67.1% [95% CI 63.1-70.9]) received antibiotics, mostly azithromycin (61.8%) and third-generation cephalosporins (37.9%). Appropriate antibiotic treatment was given to 318/550 (57.8% [95% CI 53.7-61.9]). Children aged 0-11 months vs. 24-49 months were more likely to receive appropriate antibiotic treatment (OR = 1.90 [95% CI 1.09-3.33]). Having dysentery (OR = 5.30 [95% CI 3.35-8.39]), performing blood culture (OR = 1.59 [95% CI 1.02-2.48]), and C-reactive protein (CRP) levels (OR = 1.01 [95% CI 1.01-1.02]) were positively associated with receiving appropriate antibiotic treatment. Most children with bacterial AGE received appropriate antibiotic treatment, which correlated with young age, dysentery, CRP level, and performing blood culture, suggesting more severe illness, thus supporting the clinical decisions of physicians.

Compatible co-administration of BioThrax® vaccine and ciprofloxacin—Results of a randomized open-label drug-vaccine interaction trial

The recommended treatment for post-exposure prophylaxis (PEP) following known/suspected exposure to Bacillus anthracis involves immunization with anthrax vaccine adsorbed (AVA, i.e., BioThrax® vaccine) and a course of antimicrobial therapy. A drug-vaccine interaction clinical trial was conducted to determine whether this combined treatment might modify antimicrobial exposure or vaccine immunogenicity.A Phase 2, randomized, open-label, multi-center trial involving 154 healthy adult participants was completed to evaluate the effect of AVA immunization (three doses administered subcutaneously (SC) at weeks 0, 2 and 4) on the pharmacokinetics (PK) of ciprofloxacin, as well as the effect of ciprofloxacin administration (500 mg po bid) on the immunogenicity of AVA. PK parameters were derived using noncompartmental analysis of ciprofloxacin serum concentrations. Immunogenicity was assessed using a toxin neutralizing antibody (TNA) assay resulting in 50 % neutralization factor (NF50) values. Safety was assessed via reports of adverse events (AEs), clinically significant changes in laboratory parameters and vital signs, and collection of solicited local and systemic reactogenicity reactions.Statistical analyses of the steady state (SS) and single dose PK parameters Cmax and AUC0-–12h indicated that the AVA PEP regimen did not significantly modify ciprofloxacin exposure. Comparison of the geometric mean TNA NF50 values between participants receiving AVA + ciprofloxacin and those receiving AVA alone showed that the combined treatment was non-inferior to AVA alone. The trial met all prospectively defined success criteria for the primary PK endpoint and for the secondary PK and immunogenicity endpoints. There were no deaths, SAEs or AEs leading to drug discontinuation or study withdrawal during the trial.Overall, concomitant administration of ciprofloxacin and AVA produced no significant changes in the PK profile of ciprofloxacin nor in the immunogenicity of AVA. Furthermore, this trial demonstrated that the co-administration of ciprofloxacin and AVA was well tolerated in healthy adult participants.

Study of the protective effect of ginseng against testicular oxidative stress biomarkers and its gene expression induced by ciprofloxacin

Ciprofloxacin is the first-choice member of the fluoroquinolone antibacterials for treating testicular infections, but it may harm testicular tissue because of oxidative stress. Many mechanisms are involved, like decreasing antioxidant enzymes and suppressing gene expression. This study intends to investigate the possible protective role of ginseng against ciprofloxacin-induced testicular oxidative stress and its mechanism, if any. For this purpose, 50 adult male albino rats were randomly divided into five groups, ten rats in each group. Rats in group 1 received only ciprofloxacin at a daily dose of 156.46 mg/kg. Rats in groups 2, 3 and 4 received ciprofloxacin in a daily dose of 156.46 mg/kg, ginseng in two doses of 100 and 200 mg/kg, and vitamin E as a standard in a daily dose of 100 mg/kg, respectively. Group 5 served as control and received carboxymethylcellulose in normal saline. All these treatments were applied orally during 14 14-day experimental courses. Half the animals in each group were euthanized on day 15 from the start of the treatment, while the second half was euthanized on day 60. Both testes were dissected, immediately frozen, and evaluated for oxidative stress biomarkers and gene expression antioxidant enzymes. We found that ciprofloxacin significantly (P ≤ 0.05) increased MDA and decreased total antioxidant capacity (TAC), superoxide dismutase (SOD) and catalase (CAT) compared to the control group. Also, the drug downregulated gene expression of SOD and CAT. Compared to all groups, the co-administration of ginseng or vitamin E with ciprofloxacin almost normalized antioxidant enzymes and upregulated the tested gene expressions. It could be concluded that ginseng ameliorates the testicular adverse effect of ciprofloxacin. So, it is highly recommended to be used as an adjunct remedy during ciprofloxacin administration for its antioxidant properties. Keywords: Ciprofloxacin, Gene expression, Ginseng, Infertility, ROS, Testicular oxidative stress, Vitamin-E.

Effectiveness of azithromycin and ciprofloxacin in the treatment of typhoid fever: a systematic review

Typhoid fever or commonly referred to as enteric fever is a systemic disease caused by Salmonella typhi. It often occurs in developing countries due to poor sanitation. Second-line antibiotics, including ciprofloxacin, have been widely used as the first choice treatment for typhoid fever. However, S. typhi has increased resistance to second-line antibiotics, so azithromycin has become an alternative treatment for the typhoid fever. This systematic review assessed the effectiveness of azithromycin and ciprofloxacin against typhoid fever in adults. This research used the PRISMA protocol with predefined Pubmed, Proquest, and EBSCO keywords. After removing duplicates and selecting studies according to inclusion and exclusion criterias, 17 studies about the effectiveness of azithromycin and ciprofloxacin in typhoid fever in adults from 1988-2020 were gathered. Studies were evaluated using JBI Critical Appraisal Tools. The results showed that administration of azithromycin and ciprofloxacin for typhoid fever yields average length of fever (3.5 d and 4.2 d) and average length of stay (9.3 d and 10 d), respectively. The susceptibility of S. typhi to azithromycin was 99.9%, whereas a significant decrease in its susceptibility to ciprofloxacin was observed in 2017-2020, from 4% to 2%. Azithromycin showed better effectiveness than ciprofloxacin in treating typhoid fever in adults based on S. typhi’s susceptibility, average length of fever and average length of stay from 17 studies reviewed.

Prevalence of Postoperative Nausea and Vomiting in Orthopedic Patients in Imam Khomeini Hospital Complex during 2018-2019: A Cross-Sectional Study

Background: Postoperative nausea and vomiting (PONV) is one of the most common postoperative complaints of the patients that affects the surgical outcome, quality of life, length of hospital stay, and costs. The prevalence of nausea and vomiting is estimated at 52% and 25% within the first 24 hours after surgery. Many risk factors have been identified for PONV, including female gender, being a non-smoker, young age, general anesthesia, use of volatile anesthetics and Nitrous Oxide, and duration of anesthesia. Following receiving reports indicating an unusually high prevalence of PONV in the male orthopedic ward of Imam Khomeini Hospital Complex despite applying regional techniques, the present study was conducted to investigate its prevalence and possible reasons.
 Methods: After obtaining informed consent, 300 patients admitted to male and female orthopedic wards of Imam Khomeini Hospital complex that had undergone surgery within the past 48 hours were interviewed in person and their medical records were reviewed.
 Results: Of 300 patients, 61 (20.3%) had nausea and 39 (13%) had vomiting. Three patients (1%) experienced recurrence of PONV after treatment. The risk factors associated with PONV were female gender, history of motion sickness, general anesthesia with sodium thiopental, atracurium, IV lidocaine, isoflurane, neostigmine, and postoperative administration of ciprofloxacin.
 Conclusion: The prevalence of PONV was lower than other studies, which was in contrast to reports received from the ward, indicating a reduction in PONV following the use of regional techniques.

Arthralgia as an unwanted effect of ciprofloxacin usedin combination with other drugs – a case report

The study discusses a case of a patient who developed joint pain after ciprofloxacin administration. The patient hada history of polypharmacy – the underlying cause of the described symptoms, which resulted from pharmacokineticinteractions and additive adverse effects.

URINARY TRACT DISEASES IN MALE PERISAN CAT

Urinary tract diseases are one of the various problems that can occur in pets, especially cats. Urolithiasis, kidney failure, urinary tract infections are examples of disorders of the urinary tract which are often a problem in cats. This treatment aims to discuss diagnostic and treatment techniques in Persian cats with urinary tract disorders. A 3-year-old male Persian cat came to the Teaching Animal Hospital, Udayana University, because he had dysuria and had hematuria 3 months ago before being examined. Supporting examinations include a complete blood count, ultrasound examination, dipstick test and urine sedimentation examination. Blood tests showed that the cat had leukocytosis, ultrasonography showed hyperechoic crystalline particles of urine in the lumen of the urinary bladder, thickening of the muscularis part of the bladder wall and results of urine sedimentation showed crystals of magnesium ammonium phosphate (struvite) and calcium oxalate. The diagnosis is LUTD due to thickening of the muscularis wall of the VU and the presence of struvite and calcium oxalate crystals. with a faustal prognosis. The treatment given was insertion of a urinary catheter, administration of the antibiotic ciprofloxacin (PO) and dexamethasone (PO) anti-inflammatory drugs, as well as the herbal medicine Kejibeling® orally for 5 days. After a week of treatment, the cat can urinate smoothly. The diagnostic and therapeutic methods provided help treat cases of urinary tract disorders. Good condition monitoring and maintenance management are required during the maintenance period.

Effect of fluoroquinolones on the cardiovascular system of laboratory rabbits

Introduction. The use of fluoroquinolones is associated with prolongation of the QT interval on the cardiogram and increased risk of ventricular tachycardia. To study the mechanism of the cardiotoxic effect of fluoroquinolones and to develop methods of its prevention it is necessary to create models on laboratory animals. The aim of the work was to analyze the effect of fluoroquinolones on the electrocardiographic parameters of laboratory rabbits. Materials and methods. 20 rabbits were divided into 3 groups: 6 animals were control, 7 animals received ciprofloxacin 150 mg/kg for 14 days orally, 7 animals received levofloxacin 150 mg/kg for 14 days orally. Electrocardiography was performed before and after 14 days of drug exposure. P wave width, PQ interval, QRS complex, QT interval, corrected QT (QTc), RR interval were analyzed. Data are presented as median and interquartile range. Results. Rabbits treated with ciprofloxacin showed a prolongation of the QTc interval compared with controls (QTc according to Bazett 306.2 (285.8; 319.8) versus 271.1 (255.2; 285.8) ms, p = 0.022; QTc according to Frederick 241.4 (225.3; 245.5) ms versus 219.1 (201.1; 225.3) ms, p = 0.022), as well as P wave shortening during the experiment (from 55.0 (50 .0; 70.0) ms to 40.0 (35.0; 50.0) ms, p = 0.027). Discussion. Observed electrocardiographic changes indicate the ability of ciprofloxacin to accelerate atrial conduction, slow down ventricular myocardium repolarization and increase the risk of arrhythmias. Conclusions. Oral ciprofloxacin administration at a dose of 150 mg/kg/day for 14 days simulates cardiotoxic effect in laboratory rabbits.

Comparative Analysis of Intravenous Ceftriaxone and Ciprofloxacin for the Treatment of Bacterial Peritonitis in Liver Cirrhosis

Objective: This research aimed to evaluate the relative benefits of intravenous ciprofloxacin and ceftriaxone for the treatment of bacterial peritonitis in cirrhotic liver patients. Study Design: Randomized control trial Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital Lahore in the period from March, 2022 to August, 2022. Methods: Total 130 patients of bacterial peritonitis in liver cirrhosis were included. Patients were undergone for abdomen ultrasound to diagnose liver cirrhosis. Following the acquisition of written informed consent, participants' personal information (such as age, sex, and residence) was meticulously documented. Patients were equally divided in two groups. Group I received intravenous ceftriaxone 1g 12 hourly among 65 patients and 65 cases of group II received ciprofloxacin 200mg 12 hourly for 6 days. Effectiveness among both groups were assessed. Results: There were 44 (67.7%) males and 21 (32.3%) females in group I and in group II 52 (80%) males and 13 (20%) females. Patients mean age in group I was 39.10±6.29 years and in group II mean age was 41.7±3.50 years. We found that majority of the cases were from urban areas 37 (56.9%) in group I and 39 (60%) cases in group II. Frequency of effectiveness in group I was 49 (75.4%) and in group II efficacy found in 47 (72.3%) cases. Post-treatment complications in group I was 7 (10.8%) and in group II found in 6 (9.2%) cases. Satisfaction rate among patients was almost equal 46 (70.8%) and 45 (62.9%) in group I and II. Conclusion: The findings of this research indicate that the administration of ciprofloxacin intravenously is just as effective as the administration of ceftriaxone intravenously for the treatment of spontaneous bacterial peritonitis in cirrhotic cases.

Chromatographic analysis of ciprofloxacin and metronidazole in real human plasma: green analytical chemistry perspective.

Background: Ciprofloxacin and metronidazole are beneficial for treating mixed aerobic/anaerobic infections. Methods: Following the oral administration of ciprofloxacin and metronidazole in healthy volunteers, TLC and HPLC methods were described for their analysis in plasma samples. In the first method, a stationary phase of silica gel TLC F254 plates was used using acetone/water/triethylamine/glacial acetic acid (8:2:0.25:0.1 v/v). The second approach used a C18 column and methanol/aqueous 0.05% triethylamine (25:75 v/v), with a flow rate of 1ml/min and detection at 325nm. Four green metrics were used to evaluate the approaches' environmental impact. Conclusion: The study provided the sensitivity required for determination of the two drugs in the collected samples. The findings showed that results were within permitted ranges with minimal environmental impact.

Administration of ciprofloxacin through a nasogastric tube in pediatric oncology and stem cell transplantation patients.

Pediatric oncology and hematopoietic stem cell transplantation patients are facing many gastrointestinal side effects of chemotherapy, including nausea, vomiting, mucositis, and diarrhea. International guidelines advise early enteral tube feeding as the first option of nutritional support in children undergoing myeloablative hematopoietic stem cell transplantation. When using enteral feeding tubes for nutritional purposes as well as drug administration, some pharmaceutical, nursing, and technical issues have to be taken into account. Ciprofloxacin is a fluoroquinolone, widely used because of its broad spectrum antimicrobial activity and favorable pharmacokinetic properties. However, its co-administration with polyvalent cations (as present in enteral feeding) makes the absorption of ciprofloxacin more difficult and may alter the pharmacokinetic parameters. Literature data are conflicting on how long the enteral feeding should be discontinued for patients receiving ciprofloxacin via an enteral feeding tube, ranging from 2 h before to 6 h after the administration of ciprofloxacin. Our research question was guided by challenges and concerns of nurses about the delay time between ciprofloxacin administration and restart of the enteral feeding without compromising the nutritional intake of the children. Our guideline was adapted, nurses were instructed accordingly, and patient leaflets with correct information were created.

The Effect of Ciprofloxacin on Prostate-Specific Antigen (PSA)

Increased PSA levels can be caused by prostate cancer, prostate infection, and BPH. Several studies report that the use of antibiotics can affect PSA levels. This study aims to determine the effect of ciprofloxacin administration in patients with prostate-specific antigen values ??of 4-10 ng/mL. This was an analytical study with a prospective cohort design. This study was conducted at Dr. M. Djamil Hospital, Padang starting from July 2022 until October 2022. The sampling technique used non-probability sampling with consecutive sampling method. The patient was given the antibiotic ciprofloxacin 2x500 mg for 2 weeks. PSA measurements were carried out before and after administration of antibiotics. There were 20 subject with an average age of 62.65 years (52-79). The mean of initial PSA value was 6.53 ng/mL and the final PSA value was 5.76 ng/mL. There was a significant difference between PSA levels before and after administration of ciprofloxacin (p=0.000). The use of antibiotics in patients with PSA levels of 4-10 ng/ml can reduce PSA levels.

Changes in antibiotic residues and the gut microbiota during ciprofloxacin administration throughout Silkie chicken development

The use of antibiotics leads to antibiotic residues in livestock and poultry products, adversely affecting human health. Ciprofloxacin (CFX) is a broad-spectrum antibiotic shared between animals and humans that is useful in treatments besides infections. However, changes in the gut microbiota caused by CFX and the possible link with the elimination of CFX residues have not been investigated. Herein, we used the Silkie chicken model to study the changes in the gut microbiota during the entire CFX-metabolic repertoire. We detected CFX residues in different tissues and showed that the elimination time of CFX from different tissues was dissimilar (liver > kidney > chest muscle > skin). Analysis of liver and kidney injury biomarkers and plasma antioxidant indices indicated slight hepatotoxicity and nephrotoxicity in the Silkie chickens. Importantly, the changes in the gut microbial community predominantly occurred early in the metabolic process. Correlation analysis revealed that the particular bacterial microbiota were associated with the pharmacokinetics of CFX in different Silkie chicken tissues (e.g., aerobic bacteria, including Escherichia and Coprococcus, and anaerobic bacteria, including Fusobacterium, Ruminococcus, Bifidobacterium, and Eubacterium). Collectively, certain microbiota may boost antibiotic metabolism and participate in restoring the microbial consortia after CFX is metabolized. Therefore, regulating the core intestinal microbiota may reduce foodborne antibiotics and accelerate the development of drug resistance.

Evaluation of delaying effects of different short-term dosage regimens of topical ciprofloxacin on corneal ulcer healing in an avian model.

Knowledge on possible delaying effects of topical ciprofloxacin on corneal ulcer healing is scarce in avian patients. The study evaluates effects of different dosage regimens of topical ciprofloxacin on healing of corneal ulcer in an avian model. One hundred and fifty adult layers were randomly allocated into two equal categories each consisted of 5 groups (n = 15): 1, negative control (NC, normal cornea); 2, positive control (PC) (birds with experimental corneal ulcer); and 3, 4 and 5, birds with corneal injury that received ciprofloxacin 0.3% topically q6h, q8h and q12h, respectively for 3 (category 1) or 5 days (category 2). Corneas were excised for histopathological evaluation and determination of MMP-9 expression. While no significant difference was observed in daily-measured fluorescein-stained ulcer size among ciprofloxacin-treated birds and PC group in category 1, birds in PC group of category 2 had significantly smaller ulcers as compared to antibiotic-treated birds at the end of experiment (p<0.01 for all cases). Histopathological evaluations at the end of the experiment showed no significant difference among PC and ciprofloxacin-treated birds of both categories for almost all of the assayed parameters. Over expression of MMP-9 mRNA was observed in PC group after 3 and 5 days of ulcer induction compared to NC groups. Its expression in ciprofloxacin-treated birds of both categories remained close to PC groups. While ciprofloxacin administration for 3 days does not affect ulcer healing, it delays healing process at the end of 5 days of treatments in an avian model of corneal ulcer injury. This delaying effect is not associated with a drastic change in MMP-9 expression.

The Prospective Effect of Cinnamon and Chia on Submandibular Salivary Glands After Ciprofloxacin Administration in Albino Rats (Histological, Histochemical, and Ultrastructural Study).

Ciprofloxacin (CPFX®) is potent fluoroquinolone but has severe side effects. Cinnamon (CIN) and chia seeds are potent antioxidants. The current work aimed to compare the effect of CIN extract and chia seeds on CPFX®-treated submandibular salivary glands (SMGs). Thirty-two male albino rats were divided into four groups: Group 1: received saline. Group 2: received CPFX®. Group 3: received CIN extract after 4 h of CPFX® administration. Group 4: received ground chia seeds after 4 h of CPFX® administration. After 10 days, histological, histochemical, and ultrastructural examinations were done. Different examinations illustrated normal features of SMG in Groups 1 and 3. Group 2 showed degenerative signs. Group 4 showed normal features in some areas. Statistical results illustrated that Group 2 had highest mean vacuolation area%. Highest mean of PAS optical density (OD) was for Group 2. Concerning mercuric bromophenol blue stain OD; Group 1 showed highest mean OD. CPFX® has the deteriorative effect on SMG structure and ultrastructure. It leads to increased levels of glycosaminoglycans (GAGs) and decreased levels of total proteins. CIN extract showed more ameliorative effect compared to chia seeds.

Impact of mucositis on oral bioavailability and systemic exposure of ciprofloxacin Gram-negative infection prophylaxis in patients with haematological malignancies.

Patients with haematological malignancies frequently endure neutropenia and gastrointestinal (GI)-mucositis after high-dose chemotherapy. In these patients, ciprofloxacin is used for Gram-negative infection prophylaxis. We investigate ciprofloxacin pharmacokinetics after oral administration in patients with haematological malignancies and explore the impact of GI-mucositis on oral bioavailability and clearance in order to assure adequate systemic exposure. Adult haematological patients from two Dutch University Medical Centres received 500 mg twice daily oral ciprofloxacin for Gram-negative prophylaxis. The ciprofloxacin plasma concentrations were collected at various timepoints after oral ciprofloxacin administration and at various days after completion of chemotherapy. Data obtained after oral and intravenous ciprofloxacin administration in 28 healthy volunteers without mucositis served as a control group (391 samples). For haematological patients the degree of GI-mucositis was assessed using the Daily Gut Score (DGS), plasma citrulline and albumin. Data were analysed by non-linear mixed-effects modelling. In total, 250 blood samples were collected in 47 patients with a wide variety of haematological malignancies between 0-30 days after start of chemotherapy. Mucositis was generally mild [DGS median (IQR) 1 (1-1) and citrulline 16 μmol/L (12-23)]. The time to Cmax was slower in haematological patients compared with healthy volunteers although no association with the degree of mucositis (defined as DGS or citrulline) could be identified. Ciprofloxacin bioavailability and clearance were 60% and 33.2 L/h, respectively. This study supports oral dosing of ciprofloxacin as Gram-negative infection prophylaxis in haematological patients with mild-to-moderate mucositis capable of oral intake.

Ciprofloxacin-Loaded Zein/Hyaluronic Acid Nanoparticles for Ocular Mucosa Delivery.

Bacterial conjunctivitis is a worldwide problem that, if untreated, can lead to severe complications, such as visual impairment and blindness. Topical administration of ciprofloxacin is one of the most common treatments for this infection; however, topical therapeutic delivery to the eye is quite challenging. To tackle this, nanomedicine presents several advantages compared to conventional ophthalmic dosage forms. Herein, the flash nanoprecipitation technique was applied to produce zein and hyaluronic acid nanoparticles loaded with ciprofloxacin (ZeinCPX_HA NPs). ZeinCPX_HA NPs exhibited a hydrodynamic diameter of <200 nm and polydispersity index of <0.3, suitable for ocular drug delivery. In addition, the freeze-drying of the nanoparticles was achieved by using mannitol as a cryoprotectant, allowing their resuspension in water without modifying the physicochemical properties. Moreover, the biocompatibility of nanoparticles was confirmed by in vitro assays. Furthermore, a high encapsulation efficiency was achieved, and a release profile with an initial burst was followed by a prolonged release of ciprofloxacin up to 24 h. Overall, the obtained results suggest ZeinCPX_HA NPs as an alternative to the common topical dosage forms available on the market to treat conjunctivitis.

Ciprofloxacin May Cause an Anxiety‐like Phenotype in a Rodent Model of Fluoroquinolone Associated Disability

Fluoroquinolones (FQ) are one of the most commonly prescribed antibiotics used to treat several infections including urinary tract infections, bacterial bronchitis, and bacterial gastroenteritis. However, the FDA has restricted their use to life‐threatening infections only, or for infections for which other antibiotics do not show therapeutic efficacy. The most frequent side‐effects reported include common gastrointestinal reactions (nausea, vomiting) and severe side effects, including Central Nervous System adverse reactions such as dizziness, insomnia, and severe mood disorders. For this reason, the existence of Fluoroquinolones‐Associated Disability has been proposed as the constellation of disabling side effects that may arise following administration of these antibiotics. Other preliminary data from our laboratory shows that administration of 20 mg/kg of ciprofloxacin (CPX), one of the most commonly prescribed FQs, permanently accelerates gastrointestinal transit. The goal of this study is to test whether the same dosage of CPX affects anxiety‐ and depression‐like behaviors in rats, and whether or not these behavioral changes are correlated to the observed gastrointestinal dysfunction. 3 males and 3 female rats received 20mg/kg of CPX through oral gavage once a day for 14 consecutive days. The Elevated plus‐maze test (EPM) and Sucrose Preference Test (SPT) were administered before the beginning of the treatment with CPX (baseline) and once weekly for a total of 4 weeks. At this dose, CPX did not affect the rats' preference for 1% sucrose water vs regular water in the SPT test. However, while we did not observe any differences in the time spent in the open or closed arm, nor in the number of entries in either arms, the EPM test showed that there was a significant difference in the time spent in the neutral zone for male CPX treated rats at 7, 21, and 28 testing days compared to baseline. This data shows that 20 mg/kg of CPX do not induce anhedonia, a measure of depression‐like behavior, but can induce an anxious phenotype in male rats only, which does not appear to be associated with the observed acceleration of gastrointestinal transit. Future experiments will determine whether this behavior is associated with an increase in anxiety, as observed in numerous clinical cases, or if it is caused by either a decrease in motor performance or cognitive abilities following CPX administration.