Serum levels of ciprofloxacin after single oral doses in patients with septicemia
Ciprofloxacin serum levels were measured after administration of the drug to 36 patients with septicemia (at least one positive blood culture) who were able to take oral medication. Patients were randomly allocated to receive ciprofloxacin 500 mg p.o. (n=21) or 200 mg i.v. over 30 min (n=15). A first dose was administered 18–30 h after the last positive blood culture (day 1), and a second dose four days later (day 5) in some patients. In addition to ciprofloxacin, standard antibiotics were administered. Organisms isolated wereEscherichia coli (15), other gram-negative bacteria (6),Streptococcus pneumoniae (7),Staphylococcus aureus (2), and other gram-positive bacteria (6). None of the patients vomited. Ciprofloxacin serum concentrations 1 h after oral administration were in the range 0.09–2.32 mg/l, and 2 h after administration in the range 0.5–7.27 mg/l. The average terminal half-life was 8.6 h. In individual patients serum concentrations and area-under-the-curve values were compared. Poor correlation was found between values measured on day 1 and day 5 after oral administration, whereas the correlation was excellent after i.v. administration. Serum levels 2 h after oral administration were 30–900 times the MICs for the gram-negative organisms, but were in the range of the MICs for the gram-positive organisms in some cases. In conclusion, ciprofloxacin serum levels are difficult to predict in septicemia patients after oral administration, but probably suffice to treat infections caused by gram-negative organisms.
KeywordsOral Administration Serum Concentration Staphylococcus Aureus Single Oral Dose Streptococcus Pneumoniae
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Wolfson, J. S., Hooper, D. C.
The fluoroquinolones: structures, mechanisms of action and resistance, and spectra of activity in vitro. Antimicrobial Agents and Chemotherapy 1985, 28: 581–586.PubMedGoogle Scholar
Clinical pharmacokinetics of the newer antibacterial 4-quinolones. Clinical Pharmacokinetics 1988, 14: 96–121.PubMedGoogle Scholar
LeBel, M., Barbeau, G., Bergeron, M. G., Roy, D., Valleé, F.
Pharmacokinetics of ciprofloxacin in elderly subjects. Pharmacotherapy 1986: 6: 87–91.PubMedGoogle Scholar
Guay, R. P. D., Awni, W. M., Peterson, P. K., Obaid, S., Breitenbacher, R., Matzke, G. R.
Pharmacokinetics of ciprofloxacin in acutely ill and convalescent elderly patients. American Journal of Medicine 1987, 82, Supplement 4A: 124–129.CrossRefGoogle Scholar
Wingender, W., Graefe, K. H., Gau, W., Förster, D., Beermann, D., Schacht, P.
Pharmacokinetics of ciprofloxacin after oral and intravenous administration in healthy volunteers. European Journal of Clinical Microbiology 1984, 3: 355–359.PubMedGoogle Scholar
Brumfitt, W., Franklin, I., Grady, D., Hamilton-Miller, J. M. T., Illiffe, A.
Changes in the pharmacokinetics of ciprofloxacin and fecal flora during administration of a 7-day course to human volunteers. Antimicrobial Agents and Chemotherapy 1984, 26: 757–761.PubMedGoogle Scholar
Rohner, P., Auckenthaler, R.
Comparison of Roche Septichek and Oxoid Signal blood culture systems. European Journal of Clinical Microbiology and Infectious Diseases 1989, 8: 150–153.CrossRefGoogle Scholar
Auckenthaler, R., Michéa-Hamzehpour, M., Pechère, J. C.
In vitro activity of newer quinolones against aerobic bacteria. Journal of Antimicrobial Chemotherapy 1986, 17, Supplement B: 29–39.PubMedGoogle Scholar
Bergan, T., Thorsteinsson, S. B., Solberg, R., Bjornskau, L., Kolstad, I. M., Johnsen, S.
Pharmacokinetics of ciprofloxacin: intravenous and increasing oral doses. American Journal of Medicine 1987, 82, Supplement 4A: 97–102.PubMedGoogle Scholar
Ledergerber, B., Bettex, J.-D., Joos, B., Flepp, M., Lüthy, R.
Effect of standard breakfast on drug absorption and multiple-dose pharmacokinetics of ciprofloxacin. Antimicrobial Agents and Chemotherapy 1987, 27: 350–352.Google Scholar
Ball, A. P., Fox, C., Ball, M. E., Brown, I. R. F., Willis, J. V.
Pharmacokinetics of oral ciprofloxacin, 100 mg single dose, in volunteers and elderly patients. Journal of Antimicrobial Chemotherapy 1986, 17: 629–635.PubMedGoogle Scholar
Stutman, H. R., Shalit, I., Marks, M. I., Greenwood, R., Chartrand, S. A., Hilman, B. C.
Pharmacokinetics of two dosage regimens of ciprofloxacin during a two-week therapeutic trial in patients with cystic fibrosis. American Journal of Medicine 1987, 82, Supplement 4A: 142–145.PubMedGoogle Scholar
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