This paper is only available as a PDF. To read, Please Download here.
Abstract
In a review of the US Bayer ciprofloxacin (CIP) database, an analysis was undertaken
to summarize the effectiveness and tolerability of CIP 750 mg BID in the treatment
of patients with acute exacerbations of chronic bronchitis (AECB) and pneumonia. In
five controlled studies, comparator (COMP) agents included ampicillin, intravenous
cefuroxime/cefaclor, and other unspecified agents. Primary efficacy end points were
clinical success (resolution plus improvement) and bacteriologic eradication at the
end of therapy. The incidence of adverse events for CIP 750 mg BID was compared with
that for COMP and with that in the CIP 500-mg-BID AECB and pneumonia clinical trials
database. In five uncontrolled studies, 443 patients received CIP 750 mg BID; in 5
controlled trials comprising 344 patients, 169 received CIP 750 mg BID and 175 received
COMP. Clinical success for CIP was 93% (368/396) and 99% (160/162), respectively,
in the uncontrolled and controlled studies versus 98% (156/160) for COMP agents. Corresponding
bacteriologic eradication rates for CIP 750-mg-BID—treated patients were 77% (273/356)
and 95% (122/128), respectively, and 77% (96/125) for COMP agents. Overall bacteriologic
eradication by organism for CIP 750 mg BID included Streptococcus pneumoniae 96% (51/53), Haemophilus influenzae 98% (92/94), Haemophilus parainfluenzae 100% (56/56), Moraxella catarrhalis 100% (14/14; 13 of 14 organisms were isolated in patients with AECB), and Pseudomonas aeruginosa 66% (135/204). Drug-related adverse events were reported in 113 (26%) CIP 750-mg-BID—treated
patients in uncontrolled trials and in 62 (37%) CIP 750-mg-BID— and 61 (35%) COMP-treated
patients in controlled trials. In the combined data from the CIP 750-mg-BID uncontrolled
and controlled trials, adverse events occurred with similar frequency compared with
COMP except for nausea (CIP 10%, COMP 7%) and diarrhea (CIP 3%, COMP 13%). In conclusion,
CIP 750 mg BID provided excellent clinical success rates in the treatment of patients
with AECB and pneumonia. CIP 750 mg BID was well tolerated compared with the COMP
agents administered.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Chronic bronchitis and acute infectious exacerbations.in: Mandell GL Bennett JE Dolin R 4th ed. Principles and Practice of Infectious Diseases. Churchill Livingstone, New York1995: 608-612
- Epidemiology of chronic airway disease.Chest. 1989; 96 (Suppl): 302S-306S
- A new national strategy for COPD.J Respir Dis. 1997; 18: 365-368
- Epidemiology of community-acquired respiratory tract infections in adults: Incidence, etiology, and impact.Am J Med. 1985; 78: 32-37
- Prognosis and outcomes of patients with community-acquired pneumonia: A meta-analysis.JAMA. 1995; 275: 134-141
- Prevalence of antimicrobial resistance among 723 outpatient clinical isolates of Moraxella catarrhalis in the United States in 1994 and 1995: Results of a 30-center national surveillance study.Antimicrob Agents Chemother. 1996; 40: 2884-2886
- Antibiotic resistance among clinical isolates of Haemophilus influenzae in the United States in 1994 and 1995 and detection of beta-lactamase positive strains resistant to amoxicillin-clavulanate: Results of a national multicenter study.Antimicrob Agents Chemother. 1997; 41: 292-297
- A multicentre collaborative study of the antimicrobial susceptibility of community-acquired, lower respiratory tract pathogens 1992–1993: The Alexander Project.J Antimicrob Chemother. 1996; 38 (Suppl A): 1-57
- Results of the Alexander Project: A continuing, multicenter study of the antimicrobial susceptibility of community-acquired lower respiratory tract bacterial pathogens.Diagn Microbiol Infect Dis. 1996; 25: 169-181
- Can antimicrobial activity be maintained? An appraisal of orally administered drug used for respiratory tract infections.Diagn Microbiol Infect Dis. 1997; 27: 21-28
- Antimicrobial resistance of Streptococcus pneumoniae recovered from outpatients in the United States during the winter months of 1994 to 1995: Results of a 30-center national surveillance study.Antimicrob Agents Chemother. 1996; 40: 1208-1213
- The activity of fluoroquinolones and other antimicrobial agents against community isolates of S pneumoniae, H influenzae, and M catarrhalis.Abstract presented at the 37th Interscience Conference on Antimicrobial Agents and Chemotherapy. 2811997; (Toronto, Canada)
- Pneumococcal resistance to the third-generation cephalosporins: Clinical, laboratory and molecular aspects.Int J Antimicrob Agents. 1994; 4: 63-67
- In vitro activity of Bay 09867, a new quinolone derivative, compared with those of other antimicrobial agents.Antimicrob Agents Chemother. 1983; 23: 559-564
- Ciprofloxacin, quinolone carboxylic acid compound active against aerobic and anaerobic bacteria.Antimicrob Agents Chemother. 1984; 25: 319-326
- Respiratory tract penetration of quinolone antimicrobials: A case in study.Pharmacotherapy. 1991; 11: 38-49
- Ciprofloxacin increases serum levels of theophylline.Am J Med. 1987; 82 (Suppl 4A): 115-118
- Infectious complications with respiratory pathogens despite ciprofloxacin therapy.NEJM. 1991; 325: 520-521
- Dangers of oral fluoroquinolone treatment in community acquired upper respiratory tract infections.BMJ. 1994; 308: 191-192
- Temafloxacin compared with ciprofloxacin in mild to moderate lower respiratory tract infections in ambulatory patients. A multicenter, double-blind, randomized study.Chest. 1991; 100: 1497-1502
- Safety and efficacy of temafloxacin in lower respiratory tract infections: A randomized, double-blind trial.J Antimicrob Chemother. 1992; 30: 89-100
- A double-blind study of once-daily temafloxacin in the treatment of bacterial lower respiratory tract infections.J Antimicrob Chemother. 1991; 28 (Suppl C): 73-79
- Sequential intravenous/oral ciprofloxacin compared with parenteral ceftriaxone in the treatment of hospitalized patients with community-acquired pneumonia.Infect Dis Clin Prac. 1996; 5: 265-272
- Treatment of severe pneumonia in hospitalized patients: Results of a multicenter, randomized, double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin.Antimicrob Agents Chemother. 1994; 38: 547-557
- Lower respiratory tract infection therapy—the role of ciprofloxacin.J Intern Med Res. 1995; 23: 315-327
- Efficacy of ciprofloxacin and clarithromycin in complicated acute bacterial exacerbations of chronic bronchitis: Interim analysis.Clin Ther. 1997; 19: 989-1001
Article info
Identification
Copyright
© 1998 Published by Elsevier Inc.