Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The chemistry, mechanism of action, antimicrobial spectrum, pharmacokinetics, clinical efficacy, adverse effects, and dosage and administration of ciprofloxacin and norfloxacin are reviewed, and mechanisms of antimicrobial resistance and drug and laboratory interactions are described. Norfloxacin is the first antimicrobial in the fluoroquinolone class to be marketed in the United States; ciprofloxacin is under investigation in clinical trials. The fluoroquinolones are structurally related to nalidixic acid. The activity and spectrum are enhanced by the addition of 6-fluoro and 7-piperazino substituents. Quinolone antimicrobials appear to inhibit DNA gyrase, an enzyme specific and essential for all bacteria, as their primary mechanism of action. As a result, DNA synthesis is inhibited. Ciprofloxacin and norfloxacin are active against gram-negative enteric bacteria, Pseudomonas aeruginosa, Haemophilus influenzae, and Neisseria gonorrhoeae. Ciprofloxacin has good activity against Staphylcoccus spp., including methicillin-resistant Staph. aureus. Norfloxacin generally is less potent than ciprofloxacin, particularly against Ps. aeruginosa and Staph. aureus. Peak concentrations occur about one to two hours after an oral administration of either drug. Both drugs are widely distributed in body fluids and tissues and are eliminated by renal excretion, metabolism, and biliary excretion. Dosage reductions are required in severe renal dysfunction. Ciprofloxacin and norfloxacin are effective agents for treating urinary-tract infections, including infections caused by Ps. aeruginosa. The recommended dosage of norfloxacin for urinary-tract infections in adults is 400 mg orally every 12 hours; the drug should be given for 7 to 10 days in uncomplicated infections and for 10 to 21 days in complicated ones. The fluoroquinolones may be useful for treating chronic bacterial prostatitis. Ciprofloxacin is potentially useful for treating sexually transmitted diseases. Ciprofloxacin is active against N. gonorrhoeae, including beta-lactamase-producing strains and strains that are resistant to tetracycline, and Chlamydia spp. Use of ciprofloxacin for treating gastrointestinal infections and for selective decontamination of the gastrointestinal tract is promising. In open studies, ciprofloxacin has been effective against a variety of infections caused by susceptible organisms. Resistance to ciprofloxacin has developed during treatment of infections caused by Ps. aeruginosa, Staph. aureus, and Serratia marcescens. The most frequently reported adverse effects of either drug are gastrointestinal complaints, headache, and dizziness.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Ciprofloxacin and norfloxacin, two fluoroquinolone antimicrobials. 331 72

This review covers 2346 norfloxacin treated patients in clinical trials world wide. These studies show that 400 mg of norfloxacin b.i.d. was effective and compared favorably with other standard oral agents in the treatment of urinary tract infections, including complicated and recurrent infections in men. This regimen given b.i.d. or t.i.d. was also effective in the treatment of acute gastroenteritis due to common gastrointestinal pathogens such as enterotoxigenic Escherichia coli, Salmonella spp., Shigella spp., Campylobacter spp. as well as less common organisms. A single 800 mg dose was effective in the treatment of gonorrhoea including patients with extra genito-urinary involvement and penicillinase producing strains of Neisseria gonorrhoeae. Preliminary data from ongoing trials have also shown that norfloxacin is effective in the prophylaxis of traveller's diarrhoea and infections in the granulocytopenic patient. These various regimens of norfloxacin were well tolerated with a low incidence (less than 3%) of drug related adverse experiences. The most common adverse experiences were nausea, headache, dizziness, rash, elevation of liver enzymes and eosinophilia.
 ...
PMID:World-wide clinical experience with norfloxacin: efficacy and safety. 353 57

A comparative study of the new antibacterial agent, rosoxacin, a quinoline derivative, with spectinomycin was made in women with uncomplicated cervical, urethral, pharyngeal, and rectal gonorrhoea. Rosoxacin was given in three oral regimens: 200 mg in a single dose, 300 mg in a single dose, and 300 mg in two doses of 150 mg four hours apart. All culture results 72 hours after administration were negative for Neisseria gonorrhoeae in all 81 women compared with 107 of 109 who received 2 g spectinomycin intramuscularly. Thirty-five of the women successfully treated with rosoxacin harboured penicillinase-producing strains of N gonorrhoeae (PPNG) and 46 non-penicillinase-producing (non-PPNG) strains. Fifty of the women treated with spectinomycin had PPNG strains and 59 non-PPNG strains. Mild self-limiting side effects, principally dizziness, occurred in varying frequency with rosoxacin, but these were difficult to evaluate owing to the characteristics of the patient population and the conditions under which the study was conducted.
 ...
PMID:Treatment of uncomplicated gonorrhoea in women. Comparison of rosoxacin and spectinomycin. 621 87

Rosoxacin, a beta-lactamase-resistant, pyridyl quinolone derivative with in vitro activity against Neisseria gonorrhoeae, was compared to an oral regimen of ampicillin plus probenecid for the treatment of uncomplicated gonococcal infection. Fifty-seven patients were evaluated for the effectiveness of the two antibiotics. Thirty (97%) of 31 patients receiving rosoxacin were cured of their infection as were 25 (96%) of 26 patients who received the oral regimen of ampicillin plus probenecid. Both drug regimens were associated with a significant number of side effects. Of the ampicillin-treated group, 29% had diarrhea and/or abdominal cramping. Of the rosoxacin-treated patients, 52% had reactions classified as central nervous system effects; these included headaches, dizziness, euphoria, and drowsiness.
 ...
PMID:A comparison of rosoxacin with ampicillin and probenecid in the treatment of uncomplicated gonorrhea. 671 Feb 84

In a randomized, double-blind, dose-ranging study, single oral doses of rosoxacin were used to treat 126 patients with uncomplicated genital or anorectal gonorrhea. Neisseria gonorrhoeae was eradicated from 5 (28%) of 18 men treated with 100 mg, compared with 101 (94%) of 108 men and women treated with 200 mg, 300 mg, or 400 mg (P less than 0.001). Susceptibility to rosoxacin was determined for 6 pretreatment gonococcal isolates from these patients and for 194 stored clinical isolates; 296 (98.7%) of these 300 isolates, including 10 strains of penicillinase-producing N. gonorrhaeae, required a minimal inhibitory concentration of less than or equal to 0.062 microgram/ml. Urethral or cervical infection with Chlamydia trachomatis coexisted with gonococcal infection in 14 (22%) of 63 patients and persisted in 7 of 10 patients treated with rosoxacin. Postgonococcal urethritis developed in 11 (34%) of 32 men who were monitored for 12 to 30 days. Sixty-four subjects (51%) developed transient dizziness, drowsiness, altered visual perceptions, or other symptoms suggestive of central nervous system dysfunction after treatment with rosoxacin, but these symptoms were not clearly dose related. Rosoxacin in doses of greater than or equal to 200 mg appears to be effective for single-dose treatment of uncomplicated gonorrhea, but further studies of its possible central nervous system toxicity are indicated.
 ...
PMID:Treatment of uncomplicated gonorrhea with rosoxacin. 679 24

A study of the new anti-bacterial agent, rosoxacin, a quinoline derivative was made in male subjects with uncomplicated acute gonorrhoea using a single oral dose of 200 mg and a single dose of 300 mg. Of the eight patients who received a single dose of 200 mg, post-treatment urethral smears and cultures for N. gonorrhoeae were positive in all and these subjects were considered as treatment failures. In contrast, a single dose of 300 mg was highly effective as all twenty-four who received this dose were cured as judged by negative urethral smears and cultures on the 7th post-treatment day. Of the thirty-eight isolates of M. gonorrhoeae obtained in the study, fifteen (39.5%) were penicillinase-producing, indicating that rosoxacin is effective in treating penicillin-resistant gonorrhoea. Mild to moderate dizziness and/or drowsiness was experienced by four of twenty-nine patients evaluated for safety on the 300 mg single dose, giving an incidence of side-effects of 14%. The symptoms were of brief duration and were self-limiting. A single oral dose of this drug appears to be an ideal treatment for the rapid cure of acute gonorrhoea.
 ...
PMID:Single oral dose rosoxacin in the treatment of gonorrhoea in males. 680 Aug 61

The antigonococcal activity of the quinolone derivative flumequine was evaluated. Of 246 strains examined, 240 (97.5%) strains showed minimum inhibitory concentrations (MICs) of flumequine of less than or equal to 0.4 microgram/ml, including three beta-lactamase-producing strains. The six remaining strains showed MICs from 3.2 to 9.6 micrograms/ml. By disc diffusion tests using 3-micrograms discs of flumequine the zones of growth inhibition correlated well with the MICs of flumequine. The effect of treatment with flumequine was compared in 239 patients with uncomplicated gonorrhoea. A single dose regimen of 1200 mg flumequine orally, a two-dose regimen of 1200 and 800 mg, and a three-dose regimen of 1200, 800, and 800 mg (six hours apart) were given. With a single dose of flumequine the failure rate was 26%. The two-dose and three-dose regimens were equally effective with an overall cure rate of 95.4%. In patients harbouring beta-lactamase-producing gonococci the infection was cured. The failures (10 men) included all of the six patients infected with flumequine-resistant gonococci. Side effects were noted by 14.6% of the patients and were mostly described as dizziness.
 ...
PMID:Quinolone derivative, flumequine, as short-term treatment for gonorrhoea. 681 49

Community-acquired pneumonia (CAP) remains a common and serious illness with approximately 2-4 million cases reported annually. Management of CAP is therapeutically challenging due to the increasing prevalence of penicillin- and macrolide-resistant pneumococci and beta-lactamase producing Haemophilus influenzae, as well as the increased recognition of 'atypical' pathogens, such as Chlamydia pneumoniae and Mycoplasma pneumoniae, and the frequent need for empiric therapy. We aimed to evaluate the safety and efficacy of moxifloxacin in the treatment of patients with CAP. To do this we carried out a prospective, uncontrolled, non-blind, Phase III clinical trial, in 27 U.S. centers. Patients included in the study were over 18 years of age with signs and symptoms of CAP confirmed by evidence of a new or progressive infiltrate on chest radiograph. The intervention used was moxifloxacin 400 mg PO once daily for 10 days. Sputum samples were collected pretherapy for Gram stain and culture for typical organisms. Culture and serological testing for Chlamydia pneumoniae and Mycoplasma pneumoniae was also performed. Susceptibility to moxifloxacin was determined by disk diffusion and MIC. Clinical and bacteriological responses were determined at the end of therapy (0-6 days post-therapy), follow-up (14-35 days post-therapy) and overall (end of therapy plus follow-up). Analyses were performed on both valid for efficacy and intent-to-treat populations. The primary efficacy variable was overall clinical resolution. Of 254 patients enrolled in the Study, 196 patients were included in the efficacy analyses. The majority of patients were male (58%) and Caucasian (85%) with a mean age of 49 years (range: 18 to 85 years). Only 3% of patients were hospitalized pretherapy. The most common pretherapy organisms identified, by culture or serology, in the valid for efficacy population (i.e. 147 organisms among 116 patients), were: Chlamydia pneumoniae (n=63; 54%), Mycoplasma pneumoniae (n=29; 25%), Streptococcus pneumoniae (n=14; 12%) and Haemophilus influenzae (n=13; 10%). End of therapy, follow-up and overall clinical resolution rates for the valid for efficacy population were 94%, 93% and 93%, respectively. The 95% CI for the overall clinical resolution rate was 88.1%, 95.9%. The overall bacteriological response for patients diagnosed by culture or serological criteria, was 91% (95% CI=84%, 96%). For patients who only met serological criteria for infection, the overall bacteriological response was 94% (60/64). Bacterial response rates for the four most commonly isolated pathogens were: 89% (56/63) for C. pneumoniae, 93% (27/29) for M. pneumoniae, 93% (13/14) for S. pneumoniae and 85% (11/13) for H. influenzae. Drug-related adverse events were reported in 33% (85/254) of moxifloxacin-treated patients. Nausea (9%), diarrhea (6%) and dizziness (4%) were the most commonly reported adverse events. Atypical organisms were isolated in high frequency among patients with CAP. Moxifloxacin 400 mg once daily for 10 days was effective and well-tolerated in the treatment of these adult patients with CAP. Moxifloxacin offers an effective treatment alternative for CAP due to both typical and atypical bacterial pathogens.
 ...
PMID:Efficacy and safety of ten day moxifloxacin 400 mg once daily in the treatment of patients with community-acquired pneumonia. Community Acquired Pneumonia Study Group. 1071 13