Ciprofloxacin In Group Research Articles

Comparison of intravenous ceftriaxone and ciprofloxacin in prevention of infection in cirrhosis patients with variceal bleeding

Background: Patients with variceal gastrointestinal bleeding are very susceptible to bacterial infections. This study was designed to examine the effectiveness of ciprofloxacin and ceftriaxone in controlling in-hospital morbidity, mortality, and infection in variceal bleeding patients. Methods: From August 2010 to August 2012, an interventional randomized controlled clinical trial was conducted in the Department of Gastroenterology, East Medical Ward, Mayo Hospital, Lahore. Adult patients who were diagnosed to have gastroesophageal variceal bleeding after endoscopic examination were included. These patients were randomly distributed to 2 groups. Group ceftriaxone: receiving injection Ceftriaxone 1000 mg intravenously 12 hourly for 7 days, Group ciprofloxacin: receiving injection ciprofloxacin 200 mg intravenously 12 hourly for 7 days. Results: Most common viral etiology was Hepatitis C in both the study groups. It was observed that in the ceftriaxone group, 4.8% had rebleeding, while in the ciprofloxacin group 5.6% had rebleeding (p=0.77), one case each had porto-systemic encephalopathy (p=0.99), 0.8% in ceftriaxone group and 3.2% in ciprofloxacin group had spontaneous bacterial peritonitis (p=0.39) and 4.8% in ceftriaxone group and 8% in ciprofloxacin group had systemic inflammatory response syndrome (p=0.31). No patients died during one week follow up. Conclusions: From our study, it was concluded that ciprofloxacin and ceftriaxone had same efficacy when used intravenously for prevention of bacterial infection and improvement in mortality and morbidity in patient of variceal bleeding. Future multicentric studies are required with a longer patient follow to support our findings.

Ciprofloxacin and levofloxacin adversely affect male infertility indicated by pharmacological, andrological and pathological evidence

Background: Drug-induced reproductive organs toxicities is an important aetiology in investigation of male infertility. The aim is to study levofloxacin effect on male reproductive system in comparison to ciprofloxacin.Methods: Twenty-five male wister rats weighted 230±20 gm and aged 8 weeks were randomly divided into five groups of five. The first group received ciprofloxacin with dose 78.23 mg/kg/day in 2 doses (therapeutic dose). The second group received the double dose of the first group ciprofloxacin. The third group received levofloxacin with dose 39.11 mg/kg/day once daily (OD) (therapeutic dose). The Fourth group received the double dose of the third group levofloxacin. However, the fifth group served as a control and received normal saline with carboxymethylcellulose OD. All treatments were administered orally for 14 days. On the 15th day, blood samples and reproductive organs were obtained from all rats. Testicular tissues were prepared for genetic testing and chemical and microscopical examination.Results: Ciprofloxacin and levofloxacin negatively altered reproductive organ weights, sperm parameters and serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) level (p<0.05). Additionally, serum testosterone level was significantly deceased in ciprofloxacin-treated group (the double dose) (p<0.05) relative to control. The difference between ciprofloxacin and levofloxacin was significant in seminal vesicle weight and serum LH and FSH level (p<0.05). Testicular histopathological changes were also found with the two drugs with different degrees. Effects of levofloxacin and ciprofloxacin were dose-dependent.Conclusions: Both ciprofloxacin and levofloxacin adversely affect andrological function that should be monitored and controlled during application of these drugs.

Pharmacokinetics of ciprofloxacin in bath medicated hybrid tilapias using enzyme linked immunosorbent assay (ELISA)

The apparent absence of established dosage regime for medicating tilapia with fluoroquinolones in the country necessitated investigating the absorption and tissue distribution of ciprofloxacin, since dosage regimes conform to accepted standards of pharmacokinetic studies. Ciprofloxacin pharmacokinetic studies were conducted on 76 hybrid tilapia weighing between 100 and 200 grams divided into two groups with each subjected to bath administration of ciprofloxacin at two different concentrations. The fishes in groups 1 and 2 were exposed by bath to 50 mg and 25 mg respectively of ciprofloxacin per litre of water. Tissue and blood samples were collected at 0.5h, 1h, 2h, 4h, and 8h during medication and drug withdrawal at 24h, 48h, and 72h, to quantify their ciprofloxacins by Enzyme Linked Immunosorbent Assay (ELISA). Peak serum concentration of ciprofloxacin in group 1 was 2,251±877 μg/L at 8 h while for group 2; it was 2,226±174 μg/L at 4 h exposure time. The t- test comparing the means of the groups 1 and 2 showed that there was no significant statistical difference (p > 0.05) on group sera, liver and kidney, except skeletal muscle ciprofloxacin concentration. The elimination half-lives in groups 1 and 2 were determined on serum ciprofloxacin values, after withdrawal of drug and were 27.75 h and 31.8 h, with rate constant of elimination being 0.025 h-1 and 0.022 h-1 respectively. Sera Area under Curve, {AUC (0.5-8h)} values were 12,159.3 and 13,194 μg/L respectively with 92.2% correlation. Prolonged high ciprofloxacin concentration was observed in tilapia skeletal muscle. High correlation in sera AUC values is suggestive of similar therapeutic action hence; it is cheaper to use the lower dose. While a prolonged high ciprofloxacin concentration in skeletal muscle has therapeutic advantage for fish, it remains a public health concern because the muscle is an edible tissue.Keywords: Bath, Ciprofloxacin, ELISA, Pharmacokinetics, Tilapia

Effect of total and partial nephrectomy on the elimination of ciprofloxacin in humans

BackgroundRenal cell carcinoma (RCC) is the most common form of kidney cancer. Surgery is a standard procedure to resect the tumor during total (TN) or partial (nephron-sparing) nephrectomy (PN). Ciprofloxacin is most often administered at the usual intravenous dose of 100–400mg/12h. The application of such low doses of ciprofloxacin as 200mg/24h carries the risk of achieving subtherapeutic concentrations even in patients with limited renal function. The aim of the study was a comparison of concentrations and pharmacokinetics for ciprofloxacin at steady-state in patients after total and partial nephrectomy and evaluation of the effectiveness of the iv dose 200mg/24h against the theoretical value of MIC, 0.5μg/ml. MethodsThe research was carried out on two groups of patients after nephrectomy: total (group 1, n=21; mean [SD], age, 62.9 [14.4] years; weight, 76.0 [14.6]kg; creatinine clearance, clcr, 90.7 [22.2]ml/min) and partial (group 2, n=15; 61.7 [9.3] years; 87.8 [16.4]kg; CLCR, 107.8 [36.4]ml/min). The patients were treated with ciprofloxacin in the dose of 200mg/24h (iv). Plasma concentrations of ciprofloxacin at steady state were measured with validated HPLC method with UV detection. ResultsThe mean values of plasma concentrations of ciprofloxacin at steady state in group 1 and 2 were: Cssmax, 2.012 and 1.345; Cssmin, 0.437 and 0.244μg/ml, respectively. The main pharmacokinetic parameters for ciprofloxacin in group 1 and 2 were as follows: AUC(0–last), 30.9 [17.9] and 19.5 [8.7]μgh/ml; AUMC(0–last), 177.91 [11.1] and 91.9 [66.5]μgh2/ml; t1/2β, 13.9 [7.7] and 9.8 [3.3]h; MRT, 16.5 [12.1] and 9.77 [5.4]h; Vd, 115.0 [67.2] and 142.2 [78.7]l; CL, 6.2 [3.3] and 10.8 [5.7]l/h, respectively. With the assumed MIC=0.5μg/ml, the values of Cssmax/MIC<10 and AUC/MIC<125 were obtained in all the patients. ConclusionIn our patients we observed significant differences in some pharmacokinetic parameters of ciprofloxacin after two types of nephrectomy.

Longitudinal on-farm study of the development of antimicrobial resistance in Campylobacter coli from pigs before and after danofloxacin and tylosin treatments

Effects of danofloxacin or consecutive fluoroquinolone and macrolide treatments on resistance development in Campylobacter have remained uncharacterised. Therefore we analysed the development of resistance in porcine Campylobacter coli before and after danofloxacin and tylosin treatments at a farrowing farm. Danofloxacin-treated (n=12, group A) and control pigs (n=15, group B) were subsequently treated with tylosin and sampled longitudinally. C. coli were isolated and susceptibilities to ciprofloxacin and erythromycin were assessed, isolates were genotyped with PFGE and resistance-related mutations were identified. Isolates from the danofloxacin-treated pigs had more frequently non-wild type MICs (above the epidemiological cut-off value (ECOFF)) for ciprofloxacin (P<0.001) and erythromycin (P<0.05) than those isolated before danofloxacin or those from the controls. Subsequent tylosin treatment increased proportion of isolates with non-wild type MICs for erythromycin in both groups A and B (P<0.01) and, interestingly, proportion of isolates with non-wild type MICs for ciprofloxacin in group B (P<0.001) with high MICs (128μg/ml). PFGE analysis revealed treatments selecting predominant genotypes with variable resistance patterns and decreasing initial diversity of genotypes. The most common genotype had mainly high MICs for ciprofloxacin among danofloxacin-treated pigs but wild type MICs (below the ECOFF) among the controls housed in the same pens. This suggests that the non-wild type isolate was rarely transmitted or outcompeting wild type genotype in the control pigs without selection pressure. Isolates exhibiting non-wild type MICs for ciprofloxacin harboured the C257T (Thr-86-Ile) mutation in the gyrA gene. In conclusion, a high dose of danofloxacin used at the farm did not prevent emergence of isolates with high MICs for ciprofloxacin. After subsequent tylosin treatment isolates had even higher MICs for ciprofloxacin and erythromycin than before the treatment. Therefore, controlled use of antimicrobials in food animal production is essential.