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Quinolones and the gastrointestinal tract

  • Current Topic: Review
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Abstract

A number of studies have evaluated the efficacy of the new fluoroquinolones for therapy of bacterial enteric diseases and for prevention of gram-negative sepsis in granulocytopenic patients. The success of the quinolones in these settings is related to several special features of these agents, including their spectrum of activity and high fecal levels, which are in turn reflected in their effect on the gastrointestinal flora. Other factors that are important, particularly for invasive disease such as typhoid fever and shigellosis, include good intracellular and bowel wall penetration, and lymph node and systemic drug concentrations many times higher than the MICs of the causative organisms. This article reviews the factors that contribute to the changes in fecal flora, and the results of clinical studies in patients with diarrhea, granulocytopenic patients, and patients with selected other infections of, or related to, the gastrointestinal tract.

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References

  1. Neu, H. C. Quinolones: a new class of antimicrobial agents with wide potential uses. Medical Clinics of North America 1988, 72: 636.

    Google Scholar 

  2. Murray, B.: Impact of fluoroquinolones on the gastro-intestinal flora. Reviews of Infectious Diseases 11, Supplement 5: 1372–1378.

  3. Wolfson, J. S., Hopper, D. C. The fluoroquinolones: structures, mechanisms of action and resistance, and spectra of activity in vitro. Antimicrobial Agents and Chemotherapy 1985, 28: 581–586.

    PubMed  Google Scholar 

  4. O'Hare, M. D., Felmingham, D., Ridgway, G. L., Grunebert, R. N. The comparative in vitro activity of twelve 4-quinolone antimicrobials against enteric pathogens. Drugs and Experimental Clinical Research 1985, 11: 253–257.

    Google Scholar 

  5. Vanhoof, R., Hubrechts, J. M., Roebben, E., Nyssen, H. J., Nulens, E., Leger, J., De Schepper, N. The comparative activity of pefloxacin, enoxacin, ciprofloxacin and 13 other antimicrobial agents against enteropathogenic microorganisms. Infection 1986, 14: 294–298.

    Article  PubMed  Google Scholar 

  6. Goossens, H., De Mol, P., Coignau, H., Levy, J., Grados, O., Ghysels, G., Innocent, H., Butzler, J. P. Comparative in vitro activities of aztreonam, ciprofloxacin, norfloxacin, ofloxacin, HR810 (a new cephalosporin), RU28965 (a new macrolide), and other agents against enteropathogens. Antimicrobial Agents and Chemotherapy 1985, 27: 388–392.

    PubMed  Google Scholar 

  7. Morris, J. G., Tenney, J. H., Drusano, G. L. In vitro susceptibility of pathogenicVibrio species to norfloxacin and six other antimicrobial agents. Antimicrobial Agents and Chemotherapy 1985, 28: 442–445.

    PubMed  Google Scholar 

  8. Barry, A. L. In vitro activity of the fluoroquinolone compounds. Antimicrobic Newsletter 1988, 5: 69–76.

    Article  Google Scholar 

  9. Delmee, M., Avesani, V. Comparative in vitro activity of seven quinolones against 100 clinical isolates ofClostridium difficile. Antimicrobial Agents and Chemotherapy 1986, 29: 374–375.

    PubMed  Google Scholar 

  10. Simor, A. E., Ferro, S., Low, D. E. Comparative in vitro activities of six new fluoroquinolones and other oral antimicrobial agents againstCampylobacter pylori. Antimicrobial Agents and Chemotherapy 1989, 33: 108–109.

    PubMed  Google Scholar 

  11. Hardy, D. J., Hanson, C. W., Hensey, D. M., Beyer, J. M., Fernandes, P. B. Susceptibility ofCampylobacter pylori to macrolides and fluoroquinolones. Journal of Antimicrobial Chemotherapy 1988, 22: 631–636.

    Google Scholar 

  12. Fernandes, P. B., Shipkowitz, N., Bower, R. R., Jarvis, K. P., Weisz, J., Chut, D. T. W. In vitro and in vivo potency of five new fluoroquinolones against anaerobic bacteria. Journal of Antimicrobial Chemotherapy 1986, 18: 693–701.

    PubMed  Google Scholar 

  13. Edlund, C., Nord, C. E. A review on the impact of 4-quinolones on the normal oropharyngeal and intestinal human microflora. Infection 1988, 16: 8–12.

    Article  PubMed  Google Scholar 

  14. Cofsky, R. D., du Bouhet, L., Landesman, S. H. Recovery of norfloxacin in feces after administration of a single oral dose to human volunteers. Antimicrobial Agents and Chemotherapy 1984, 26: 110–111.

    PubMed  Google Scholar 

  15. Edlund, C., Bergan, T., Josefsson, K., Solbert, R., Nord, C. E. Effect of norfloxacin on human oropharyngeal and colonic microflora and multiple-dose pharmaco-kinetics. Scandinavian Journal of Infectious Diseases 1987, 19: 113–121.

    PubMed  Google Scholar 

  16. Janin, N., Meugnier, H., Desnottes, J. F., Woehrle, R., Fleurette, J. Recovery of pefloxacin in saliva and feces and its action on oral and fecal floras of healthy volunteers. Antimicrobial Agents and Chemotherapy 1987, 31: 1665–1668.

    PubMed  Google Scholar 

  17. Stahl, J. P., Leclerq, P., Lefebvre, M. A., Yver, R., Bru, J. P., Letoublon, C., Fourtillan, J. B., Micoud, M. Distribution of ofloxacin into mesenteric lymph nodes. Reviews of Infectious Diseases 1988, 10, Supplement 1: 207–208.

    Google Scholar 

  18. Pecquet, S., Andremont, A., Tancrede, C. Selective antimicrobial modulation of the intestinal tract by norfloxacin in human volunteers and in gnotobiotic mice associated with a human faecal flora. Antimicrobial Agents and Chemotherapy 1986, 29: 1047–1052.

    PubMed  Google Scholar 

  19. Schaeffer, A. J., Sisney, G. A. Efficacy of norfloxacin in urinary tract infections: biological effects on vaginal and fecal flora. Journal of Urology 1985, 133: 298–300.

    PubMed  Google Scholar 

  20. De Vries-Hospers, H. G., Welling, G. W., van der Waaij, D. Influence of quinolones on throat and faecal flora of healthy volunteers. Pharmaceutisch Weekblad 1987, 9: 41–44.

    Google Scholar 

  21. Goldstein, E. J. C., Citron, D. M., Corrado, M. L. Effect of inoculum size on in vitro activity of norfloxacin against fecal anaerobic bacteria. American Journal of Medicine 1987, 82: 84–87.

    Article  Google Scholar 

  22. Edlund, C., Lindqvist, L., Nord, C. E. Norfloxacin binds to human fecal material. Antimicrobial Agents and Chemotherapy 1988, 32: 1869–1874.

    PubMed  Google Scholar 

  23. Edlund, C., Lidbeck, A., Kager, L., Nord, C. E. Effect of enoxacin on colonic microflora of healthy volunteers. European Journal of Clinical Microbiology 1987, 6: 298–300.

    PubMed  Google Scholar 

  24. Bergan, T., Delin, C., Johansen, S., Kolstad, I. M., Nord, C. E., Thorsteinsson, S. B. Pharmacokinetics of ciprofloxacin and effects of repeated dosage on salivary and feacal microflora. Antimicrobial Agents and Chemotherapy 1986, 29: 298–302.

    PubMed  Google Scholar 

  25. Brumfitt, W., Franklin, I., Grady, D., Hamilton-Miller, J. M. T., Iliffe, 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.

    PubMed  Google Scholar 

  26. Enzensberger, R., Shah, P. M., Knothe, H. Impact of oral ciprofloxacin on the faecal flora of healthy volunteers. Infection 1985, 13: 273–275.

    PubMed  Google Scholar 

  27. Hold, H. A., Lewis, D. A., White, L. O., Bastable, S. Y., Reeves, D. S. Effect of oral ciprofloxacin on the faecal flora of healthy volunteers. European Journal of Clinical Microbiology 1986, 5: 201–205.

    PubMed  Google Scholar 

  28. Rozenberg-Arska, M., Dekker, A. W., Verhoef, J. Ciprofloxacin for selective decontamination of the alimentary tract in patients with acute leukemia during remission induction treatment: the effect on fecal flora. Journal of Infectious Diseases 1985, 152: 104–107.

    PubMed  Google Scholar 

  29. Scully, B. E., Jules, K., Chin, N-X., Neu, H. C. Effect of ciprofloxacin on fecal flora of patients with cystic fibrosis and other patients treated with oral ciprofloxacin. American Journal of Medicine 1987, 82: 336–338.

    PubMed  Google Scholar 

  30. Pecquet, S., Andremont, A., Tancrede, C. Effect of ofloxacin on fecal bacteria in human volunteers. Antimicrobial Agents and Chemotherapy 1987, 31: 124–125.

    PubMed  Google Scholar 

  31. Shah, P. M., Enzensberger, R., Glogau, O., Knothe, H. Influence of oral ciprofloxacin or ofloxacin on the fecal flora of healthy volunteers. American Journal of Medicine 1987, 82: 333–338.

    Article  PubMed  Google Scholar 

  32. Edlund, C., Kager, L., Malmborg, A. S., Sjostedt, S., Nord, C. E. Effect of ofloxacin on oral and gastrointestinal microflora in patients undergoing gastric surgery. European Journal of Clinical Microbiology and Infectious Diseases 1988, 7: 135–143.

    Google Scholar 

  33. Nord, C. E., Kager, L., Heimdahl, A. Impact of antimicrobial agents on the gastrointestinal microflora and the risk of infections. American Journal of Medicine 1984, 76: 99–106.

    Article  Google Scholar 

  34. van der Waaij, D. Colonization pattern of the digestive tract by potentially pathogenic microorganisms: colonization-controlling mechanisms and consequences for antibiotic treatment. Infection 1983, 11: 99–160.

    Article  Google Scholar 

  35. Levine, M. M. Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent. Journal of Infectious Diseases 1987, 155: 377–389.

    PubMed  Google Scholar 

  36. DuPont, H. L. Gastrointestinal infections. In: Stein, J. H. (ed.): Internal medicine, Little, Brown and Co., Boston, 1987, p. 1511–1520.

    Google Scholar 

  37. DuPont, H. L., Corrado, M. L., Sabbaj, J. Use of norfloxacin in the treatment of acute diarrheal disease. American Journal of Medicine 1987, 82: 79–83.

    Article  Google Scholar 

  38. Ericsson, C. D., Johnson, P. C., DuPont, H. L., Morgan, D. R., Bitsura, J. A. M., de la Cabada, F. J. Ciprofloxacin or trimethoprim-sulfamethoxazole as initial therapy for travelers' diarrhea. Annals of Internal Medicine 1987, 106: 216–220.

    PubMed  Google Scholar 

  39. Pichler, H. E. T., Diridl, G., Stickler, K., Dietmar, W. Clinical efficacy of ciprofloxacin compared with placebo in bacterial diarrhea. American Journal of Medicine 1987, 82: 329–332.

    Article  Google Scholar 

  40. Johnson, P. C., Ericsson, C. D., Morgan, D. R., DuPont, H. L., Cabada, F. J. Lack of emergence of resistant fecal flora during successful prophylaxis of traveler's diarrhea with norfloxacin. Antimicrobial Agents and Chemotherapy 1986, 30: 671–674.

    PubMed  Google Scholar 

  41. Wistrom, J., Norrby, S. R., Burman, L. G., Lundholm, R., Jellheden, B., Englund, G. Norfloxacin versus placebo for prophylaxis against travellers' diarrhoea. Journal of Antimicrobial Chemotherapy 1987, 20: 563–574.

    PubMed  Google Scholar 

  42. Moorhead, P. J., Parry, H. E. Treatment of Sonne dysentery. Lancet 1965, ii: 913–915.

    Google Scholar 

  43. Haltalin, K. C., Nelson, J. D., Kusmiesz, H. T. Comparative efficacy of nalidixic acid and ampicillin for severe shigellosis. Archives of Diseases in Children 1973, 48: 305–312.

    Google Scholar 

  44. Hansson, H. B., Barkenius, G., Cronbert, S., Juhlin, I. Controlled comparison of nalidixic acid or lactulose with placebo in shigellosis. Scandinavian Journal of Infectious Diseases 1981, 13: 191–193.

    PubMed  Google Scholar 

  45. Salam, M. A., Bennish, M. L. Therapy for shigellosis. I. Randomized, double-blind trial of nalidixic acid in childhood shigellosis. Journal of Pediatrics 1988, 113: 901–907.

    PubMed  Google Scholar 

  46. Rogerie, F., Ott, D., Vandepitte, J., Verbist, L., Lemmens, P., Habiyaremye, I. Comparison of norfloxacin and nalidixic acid for treatment of dysentery caused byShigella dysenteriae type 1 in adults. Antimicrobial Agents and Chemotherapy 1986, 29: 883–886.

    PubMed  Google Scholar 

  47. De Mol, P., Mets, T., Lagasse, R., Vandepitte, J., Mutwewingabo, A., Butzler, J.-P. Treatment of bacillary dysentery: a comparison between enoxacin and nalidixic acid. Journal of Antimicrobial Chemotherapy 1987, 19: 695–698.

    PubMed  Google Scholar 

  48. Ruiz-Palacios, G. M. Norfloxacin in the treatment of bacterial enteric infections. Scandinavian Journal of Infectious Diseases 1986, 48: 55–63.

    PubMed  Google Scholar 

  49. Goodman, L. J., Kaplan, R. L., Petrak, R. M., Fliegelman, R. M., Taff, D., Walton, F., Penner, J. L., Trenholme, G. M. Effects of erythromycin and ciprofloxacin on chronic fecal excretion ofCampylobacter species in marmosets. Antimicrobial Agents and Chemotherapy 1986, 29: 185–187.

    PubMed  Google Scholar 

  50. Altwegg, M., Burnens, A., Zollinger-Iten, J., Penner, J. L. Problems in identification ofCampylobacter jejuni associated with acquisition of resistance to nalidixic acid. Journal of Clinical Microbiology 1987, 25: 1807–1808.

    PubMed  Google Scholar 

  51. Tanphaichitra, D., Sahaphong, S., Srimuang, S. Ofloxacin, a new quinolone, in the treatment of genitourinary and enteric infections. Infection 1986, 14: 321–323.

    Article  Google Scholar 

  52. Lo, W.-L. Ofloxacin in treatment of typhoid fever: a preliminary study. Journal of Antimicrobial Chemotherapy 1988, 5: 681–682.

    Google Scholar 

  53. Carbon, C., Weber, P., Levy, M., Boussougant, Y., Cerf., M. Short-term ciprofloxacin therapy for typhoid fever. Journal of Infectious Diseases 1987, 155: 883.

    Google Scholar 

  54. Ramirez, C. A., Bran, J. L., Mejia, C. R., Garcia, J. F. Open, prospective study of the clinical efficacy of ciprofloxacin. Antimicrobial Agents and Chemotherapy 1985, 28: 128–132.

    PubMed  Google Scholar 

  55. Hajji, M., Mdaghri, N. E., Benbachir, M., El Filali, K. M., Himmich, H. Prospective randomized comparative trial of pefloxacin versus cotrimoxazole in the treatment of typhoid fever in adults. European Journal of Clinical Microbiology and Infectious Diseases 1988, 7: 361–363.

    Article  Google Scholar 

  56. Ferreccio, C., Morris, J. G., Valdivieso, C., Prenzel, I., Sotomayor, V., Drusano, G. L., Levine, M. M. Efficacy of ciprofloxacin in the treatment of chronic typhoid carriers. Journal of Infectious Diseases 1988, 157: 1235–1239.

    PubMed  Google Scholar 

  57. Gotuzzo, E., Guerra, J. G., Benavente, L., Palomino, J. C., Carrillo, C., Lopera, J., Delgado, F., Nalin, D. R., Sabbaj, J. Use of norfloxacin to treat chronic typhoid carriers. Journal of Infectious Diseases 1988, 157: 1221–1225.

    PubMed  Google Scholar 

  58. Loffler, A., Westphalen, H. G. Successful treatment of chronic salmonella excretor with ofloxacin. Lancet 1986, i: 1206.

    Article  Google Scholar 

  59. Diridl, G., Pichler, H., Wolf, D. Treatment of chronic salmonella carriers with ciprofloxacin. European Journal of Clinical Microbiology 1986, 5: 260–261.

    PubMed  Google Scholar 

  60. Heseltine, P. N. R., Causey, D. M., Appleman, M. D., Corrado, M. L., Leedom, J. M. Norfloxacin in the eradication of enteric infections in AIDS patients. European Journal of Cancer and Clinical Oncology 1988, 24, Supplement: 25–28.

    Google Scholar 

  61. Esposito, S., Gaeta, G. B., Galante, D., Barba, D. Successful treatment with ciprofloxacin ofSalmonella typhimurium infection in an immunocompromised host. Infection 1985, 13: 288.

    Article  PubMed  Google Scholar 

  62. Connolly, M. J., Snow, M. H., Ingham, H. R. Ciprofloxacin treatment of recurrentSalmonella typhimurium septicaemia in a patient with acquired immune deficiency syndrome. Journal of Antimicrobial Chemotherapy 1986, 18: 647–648.

    PubMed  Google Scholar 

  63. Patton, W. N., Smith, G. M., Leyland, M. J., Geddes, A. M. Multiply resistantSalmonella typhimurium septicaemia in an immunocompromised patient successfully treated with ciprofloxacin. Journal of Antimicrobial Chemotherapy 1985, 16: 667–669.

    PubMed  Google Scholar 

  64. Brunner, H., Zeiler, H. J. Oral ciprofloxacin treatment forSalmonella typhimurium infection of normal and immunocompromised mice. Antimicrobial Agents and Chemotherapy 1988, 32: 57–62.

    PubMed  Google Scholar 

  65. McNulty, C. A. M., Dent, J. C., Ford, G. A., Wilkinson, S. P. Inhibitory antimicrobial concentrations againstCampylobacter pylori in gastric mucosa. Journal of Antimicrobial Chemotherapy 1988, 22: 729–738.

    PubMed  Google Scholar 

  66. Stone, J. W., Wise, R., Donovan, I. A., Gearty, J. Failure of ciprofloxacin to eradicateCampylobacter pylori from the stomach. Journal of Antimicrobial Chemotherapy 1988, 22: 92–93.

    Google Scholar 

  67. Preheim, L. C., Cuevas, T. A., Roccaforte, J. S., Mellencamp, M. A., Bittner, M. J. Ciprofloxacin and antacids. Lancet 1986, ii: 48.

    Article  Google Scholar 

  68. Hoffken, G., Borner, K., Glatzel, P. D., Koeppe, P., Lode, H. Reduced enteral absorption of ciprofloxacin in the presence of antacids. European Journal of Clinical Microbiology 1985, 4: 345.

    Google Scholar 

  69. Hirschl, A. M., Hentschel, E., Schutze, K., Nemec, H., Potzi, R., Gangl., A., Weiss, W., Pletschette, M., Stanek, G., Rotter, M. L. The efficacy of antimicrobial treatment inCampylobacter pylori-associated gastritis and duodenal ulcer. Scandinavian Journal of Gastroenterology 1988, 23: 76–81.

    Google Scholar 

  70. Bayerdorffer, E., Simon, T., Bastlein, C., Ottenjann, R., Kasper, G. Bismuth/ofloxacin combination for duodenal ulcer. Lancet 1987, ii: 1467–1468.

    Article  Google Scholar 

  71. Karp, J. E., Merz, W. G., Hendricksen, C., Laughon, B., Redden, T., Bamberger, B. J., Bartlett, J. G., Saral, R., Burke, P. J. Oral norfloxacin for prevention of gram-negative bacterial infections in patients with acute leukemia and granulocytopenia. Annals of Internal Medicine 1987, 106: 1–6.

    PubMed  Google Scholar 

  72. Dekker, A. W., Rozenberg-Arkska, M., Verhoef, J. Infection prophylaxis in acute leukemia: a comparison of ciprofloxacin with trimethoprim-sulfamethoxazole and colistin. Annals of Internal Medicine 1987, 106: 7–12.

    PubMed  Google Scholar 

  73. Winston, D. J., Winston, G. H., Nakao, S. L., Gale, R. P., Champlin, R. E. Norfloxacin versus vancomycin/polymyxin for prevention of infections in granulocytopenic patients. American Journal of Medicine 1986, 80: 884–890.

    Article  PubMed  Google Scholar 

  74. Bow, E. J., Rayner, E., Louie, T. J. Comparison of norfloxacin with cotrimoxazole for infection prophylaxis in acute leukemia. American Journal of Medicine 1988, 84: 847–854.

    Article  PubMed  Google Scholar 

  75. Winston, D. J., Ho, W. G., Champlin, R. E., Karp, J., Bartlett, J., Finley, R. S., Joshi, J. H., Talbot, G., Levitt, L., Deresinski, S., Corrado, M. Norfloxacin for prevention of bacterial infections in granulocytopenic patients. American Journal of Medicine 1987, 82: 40–46.

    Article  PubMed  Google Scholar 

  76. Young, L. S. The new fluorinated quinolones for infection prevention in acute leukemia. Annals of Internal Medicine 1987, 106: 144–146.

    PubMed  Google Scholar 

  77. Gluckman, E., Cavazzana, M., Devergie, A., Meletis, J., Arlet, G., Perol, Y., Boiron, M. Prevention des infections bacteriennes apres greffe de moelle osseuse par antibiotiques oraux a large spectre absorbables (pefloxacine, penicilline) ou non absorbables (cephalosporine, gentamicine, bacitracine). Pathologie Biologie 1988, 36: 902–906.

    PubMed  Google Scholar 

  78. Karp, J. E., Dick, J. D., Merz, W. G. Systemic infection and colonization with and without prophylactic norfloxacin use over time in the granulocytopenic, acute leukemia patient. European Journal of Cancer and Clinical Bacteriology 1988, 24, Supplement 1: 5–13.

    Google Scholar 

  79. Maschmeyer, G., Haralambie, E., Gaus, W., Kern, W., Dekker, A. W., De Vries-Hospers, H. G., Sizoo, W., Konig, W., Gutzler, F., Danenen, S. Ciprofloxacin and norfloxacin for selective decontamination in patients with severe granulocytopenia. Infection 1988, 16: 98–104.

    Article  PubMed  Google Scholar 

  80. Smith, G. M., Leyland, M. J., Farrell, I. D., Geddes, A. M. A clinical, microbiological and pharmacokinetic study of ciprofloxacin plus vancomycin as initial therapy of febrile episodes in neutropenic patients. Journal of Antimicrobial Chemotherapy 1988, 21: 647–655.

    PubMed  Google Scholar 

  81. Smith, G. M., Leyland, M. J., Farrell, I. D., Geddes, A. M. Preliminary evaluation of ciprofloxacin, a new 4-quinolone antibiotic, in the treatment of febrile neutropenic patients. Journal of Antimicrobial Chemotherapy 1986, 18: 165–174.

    Google Scholar 

  82. Kern, W., Kurrle, E., Vanek, E. Ofloxacin for prevention of bacterial infections in granulocytopenic patients. Infection 1987, 15: 427–432.

    Article  PubMed  Google Scholar 

  83. Esposito, C., Barba, D., Galante, D., Gaeta, G. B., Laghezza, O. Intestinal microflora changes induced by ciprofloxacin and treatment of portal-systemic encephalopathy (PSE). Drugs in Experimental Clinical Research 1987, 13: 641–646.

    Google Scholar 

  84. Esposito, S., Galante, D., Laghezza, O., Barba, D., Gaeta, G. B. Rapid improvement of hepatic encephalopathy associated with oral ciprofloxacin treatment. Infection 1987, 15: 364–365.

    Article  PubMed  Google Scholar 

  85. Dan, M., Verbin, N., Gorea, A., Nagar, H., Berger, S. A. Concentrations of ciprofloxacin in human liver, gallbladder, and bile after oral administration. European Journal of Clinical Pharmacology 1987, 32: 217–218.

    Article  PubMed  Google Scholar 

  86. Parry, M. F., Smego, D. A., Digiovanni, M. A. Hepatobiliary kinetics and excretion of ciprofloxacin. Antimicrobial Agents and Chemotherapy 1988, 32: 982–985.

    PubMed  Google Scholar 

  87. Dan, M., Serour, F., Gorea, A., Levenberg, A., Krispin, M., Berger, S. A. Concentration of norfloxacin in human gallbladder tissue and bile after single-dose oral administration. Antimicrobial Agents and Chemotherapy 1987, 31: 352–353.

    PubMed  Google Scholar 

  88. Kazmierczak, A., Pechinot, A., Duez, J-M., Haas, O., Favre, J-P. Biliary tract excretion of ofloxacin in man. Drugs 1987, 34: 39–43.

    PubMed  Google Scholar 

  89. Chrysanthopoulos, C. J., Skoutelis, A. T., Starakis, J. C., Arvaniti, A., Bassaris, H. P. Use of ciprofloxacin in biliary sepsis. Infection 1988, 16: 249.

    Article  PubMed  Google Scholar 

  90. Chrysanthopoulos, C. J., Skoutelis, A. T., Starakis, J. C., Anastassiou, E. D., Bassaris, H. P. Use of intravenous ciprofloxacin in respiratory tract infections and biliary sepsis. American Journal of Medicine 1987, 82: 357–359.

    Article  PubMed  Google Scholar 

  91. Houwen, R. H. J., Bijleveld, C. M. A., de Vries-Hospers, H. G. Ciprofloxacin for cholangitis after hepatic portoenterostomy. Lancet 1987, i: 1367.

    Article  Google Scholar 

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    B. E. Murray

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Murray, B.E. Quinolones and the gastrointestinal tract. Eur. J. Clin. Microbiol. Infect. Dis. 8, 1093–1101 (1989). https://doi.org/10.1007/BF01975176

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