Norfloxacin In Patients Research Articles

Norfloxacin with itopride versus norfloxacin alone in secondary prophylaxis of spontaneous bacterial peritonitis: a randomized trial

BackgroundBacterial translocation is considered the pathophysiological hallmark in the development of spontaneous bacterial peritonitis (SBP). Prokinetics can increase gastrointestinal (GIT) motility, reduce small bowel transit time, decrease bacterial translocation, and the possibility of SBP. The aim of this work was to compare the effectiveness and safety of itopride and norfloxacin versus norfloxacin only in secondary prophylaxis for cirrhotic ascitic patients with spontaneous bacterial peritonitis.ResultsRegarding the baseline clinical manifestations and laboratory investigations, there was no significant difference between both groups. The incidence of a recurrent SBP in group I, who had received itopride plus norfloxacin, reduced with a significant difference than other group II (P=0.018). The median time for recurrence of SBP was highly longer in group I than group II with a significant difference (P=0.042).ConclusionsThe combined usage of itopride with norfloxacin in patients with cirrhosis and ascites can decrease the occurrence of a recurrent SBP and significantly improve the survival of patients.Trial registrationClinicalTrials.gov Identifier: NCT04161768.

Analysis of bacterial adherence of strains of E. coli sensible and resistant to norfloxacin in patients with cirrhosis

Analysis of bacterial adherence of strains of E. coli sensible and resistant to norfloxacin in patients with cirrhosis

Analysis of bacterial adherence of strains of E. coli sensible and resistant to norfloxacin in patients with cirrhosis

Analysis of bacterial adherence of strains of E. coli sensible and resistant to norfloxacin in patients with cirrhosis

Parenteral antibiotic prophylaxis of bacterial infections does not improve cost-efficacy of oral norfloxacin in cirrhotic patients with gastrointestinal bleeding

Objective: Selective intestinal decontamination with norfloxacin is useful in the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding. However, bleeding cirrhotic patients with ascites, encephalopathy, or shock are at high risk to develop bacterial infections in spite of prophylactic norfloxacin. The aim of this study was to assess whether the addition of intravenous ceftriaxone could improve the efficacy of prophylaxis with norfloxacin in these patients. Methods: Fifty-six cirrhotic patients with gastrointestinal hemorrhage and ascites, encephalopathy, or shock were randomized into two groups: Group 1 (n = 28) received oral norfloxacin 400 mg/12 h for 7 days, and group 2 (n = 28) received norfloxacin plus intravenous ceftriaxone 2 g daily during the first 3 days of admission. Results: Ten patients were excluded because of community-acquired infection, surgery, or death within the first 24 h. The incidence of bacterial infections during hospitalization was 18.1% in group 1 and 12.5% in group 2 ( p = NS). The incidence of severe infections (spontaneous bacterial peritonitis, bacteremia, or pneumonia) was also similar in both groups: 9% in group 1 versus 8.3% in group 2 ( p = NS). There were no statistical differences between the two groups with respect to duration of hospitalization or mortality. The cost of antibiotic therapy (including prophylaxis and treatment of infections) was significantly higher in group 2. Conclusion: These results suggest that the addition of intravenous ceftriaxone during the first 3 days of hospitalization does not improve the cost-efficacy of oral norfloxacin in the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding and high risk of infection.

Effect of Discontinuing Prophylaxis with Norfloxacin in Patients with Hematologic Malignancies and Severe Neutropenia

The use of fluorinated quinolones for prophylaxis of infections in neutropenic cancer patients has led to a reduction of infections with gram-negative enteric bacilli, but there is concern about the emergence of antibiotic-resistant enterobacterial infections and a rise of gram-positive bacteremias. Due to these concerns, in mid-1995 the use of prophylactic norfloxacin was discontinued in our unit. In order to evaluate the impact of this measure on the infectious morbidity in our unit, 91 severe neutropenic episodes in 58 patients with hematologic malignancies who did not receive norfloxacin prophylaxis (NO group) were closely matched to 91 episodes in 60 patients who received norfloxacin prophylaxis (NORFLO group). There were no differences in the incidence of febrile neutropenia, fever of unknown origin or bacteremia during the first febrile episode. There was a trend for a higher rate of coagulase-negative staphylococcal bacteremia in the NORFLO group (5 vs. 11 cases in the NO and NORFLO groups, respectively, p = NS). Enterobacterial bloodstream infections were more frequent in the NO group (13 vs. 2 cases, respectively, p = 0.01), especially Escherichia coli (9 vs. 1 case, respectively, p = 0.01). Twelve of 13 enterobacterial isolates in the NO group were sensitive to the fluoroquinolones vs. 0/2 in the NORFLO group (p = 0.07). We conclude that the abrupt discontinuation of norfloxacin prophylaxis in our ward led to a rapid increase in the rate of fluoroquinolone-susceptible enterobacterial infections, with a scarce impact on infectious morbidity. This suggests that the selection of resistant flora in an inpatient ward by prophylactic antimicrobials may be reversible following the discontinuation of the prophylactic agent(s).

Corneal ulcer associated with deposits of norfloxacin

To report a case of corneal ulcer associated with deposits of norfloxacin. Case report. A 40-year-old man with right trigeminal and facial nerve palsies and decreased tear secretion developed a corneal ulcer with white deposits in the right eye. The deposits were removed and analyzed by high-performance liquid chromatography. High-performance liquid chromatography results disclosed that the deposits on the corneal surface had the same retention time as norfloxacin. The patient discontinued norfloxacin ophthalmic solution and recovered successfully. Clinicians should be aware that frequent applications of topical norfloxacin in patients with decreased tear secretion may result in deposition of the drug on the cornea.

Cefodizine (HR221) Versus Norfloxacin for Treatment of Urinary Tract Infections

Cefodizime is a stable new beta-lactamase cephalosporin chemically related to cefotaxime and with a long half-life. Its clinical efficacy and tolerability were compared with those of norfloxacin in patients with intercurrent urinary tract infections plus chronic liver diseases. Cefodizime (2 g, once a day, i.v.) and norfloxacin (400 mg, twice a day, p.o.) were randomly given to two groups of 20 patients each with urinary tract infections caused by organisms sensitive in vitro to these drugs. Cultures of midstream bladder urine, urinalysis and blood biochemical tests were performed before and after each antibiotic treatment. Clinical resolution was observed in 100% of the patients at the end of the treatments, but bacteriological eradication was obtained in 90% of the patients treated with cefodizime and 85% of those treated with norfloxacin, because of the development in five patients of asymptomatic bacteriuria (superinfections).

Postoperative prophylaxis with norfloxacin in patients requiring bladder catheters.

The effect of once daily doses of 200 mg oral norfloxacin on the occurrence of catheter-associated bacteriuria (greater than 1000 CFU/ml) and pyuria was studied in 105 post-operative gynaecologic patients. Norfloxacin was given from the second day after surgery until catheter removal. Bacteriuria developed in 32 of 51 (63%) control patients compared to 8 of 54 (15%) patients receiving norfloxacin (p less than 0.001). Pyuria was present in 22 of 51 (43%) control subjects versus only 3 of 54 (5%) patients treated with norfloxacin (p less than 0.001). Bacteria isolated from control patients comprised species of Enterobacteriaceae (40%), Staphylococcus (35%), and Streptococcus (17%); seven isolates were resistant to multiple antibiotics reflecting their nosocomial origin. In contrast, strains isolated from norfloxacin-treated patients comprised non-fermenting gram-negative rods (79%, usually Alcaligenes or Acinetobacter spp.) and faecal streptococci (12%). It is concluded that once daily doses of 200 mg oral norfloxacin are effective in reducing the rate of catheter-associated bacteriuria and pyuria following reconstructive gynaecologic surgery.