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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical presentation, complications and sensitivity pattern was studied in 30 cases of enteric fever. Fever was the main presenting feature in all. Other associated predominant presenting feature were vomiting in 15 (50%), Loose motion 9 (30%), Cough 6 (20%), headache 4 (13.33%) and altered sensorium in 2 (6.66%). The various complications observed during hospital stay were myocarditis 5 (6.16%), Paralytic ileus 2 (6.66%), Pneumonia 1 (3.33%) and Joint effusion in 2 (6.66%) cases respectively. In laboratory parameters-mild elevation of blood urea and SGOT/SGPT were detected in 1st week, which returned to normal in 2-3 weeks time. In vitro sensitivity of organism isolated (24 cases) were as follow--Chloramphenicol 7 (29.16%), Ampicillin 8 (33.33%), Gentamicin 22 (91.66%), Amikacin 24 (100%), Cefotaxime 22 (91.66%), Ciprofloxacin 24 (100%), and Ofloxacin 24 (100%). Clinical response to Ofloxacin and Ciprofloxacin was 100%, and fever subsided in 3-5 days.
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PMID:Changing profile of enteric fever--in summer-91. 130 27

Twelve cystic fibrosis patients, aged over 18, who had developed an acute respiratory exacerbation and who had Pseudomonas species isolated from their sputum, were entered into a clinical trial involving ciprofloxacin. The dosage regimen was 100 mg iv followed by 500 mg twice daily orally if less than 40 kg in weight and 200 mg iv followed by 750 mg twice daily orally if greater than 40 kg. Ciprofloxacin was well tolerated with no major side effects, except in one patient who withdrew after onset of headaches and generalized aches and pains. Eleven of the 12 patients showed clinical improvement at the end of the treatment period as determined by weight gain, Shwachman Score, Chrispin Norman Score and pulmonary function tests. MICs of Pseudomonas species isolated from the sputum at the start of the trial were in the range 0.25-4 mg/l. During therapy, sensitivity of isolates decreased and did not return to starting levels at the end of a four week follow-up period. Pharmacokinetic parameters were similar to those reported for fasting healthy volunteers by other workers except for bioavailability which was reduced in the non-fasting patients.
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PMID:Clinical and pharmacokinetic aspects of ciprofloxacin in the treatment of acute exacerbations of pseudomonas infection in cystic fibrosis patients. 259 98

Data from 1,878 courses of intravenous ciprofloxacin therapy, administered to 1,869 patients in 59 clinical trials, were analyzed for drug safety. The 985 men and 884 women had a mean age of 50 years, and more than one third were over 60 years of age. An overwhelming majority had at least one accompanying systemic illness, and the condition of more than half the patients was only fair or poor at the onset of therapy. Ciprofloxacin was administered in a unit dose of either 200 mg (68 percent of the patients) or 300 mg (28 percent) by intravenous infusion, generally over 30 minutes every 12 hours, at a mean daily dosage of 456 mg. The duration of intravenous therapy ranged from one to 57 days, with a mean of seven days; over 1,000 patients were treated for more than five days. Adverse events considered probably or possibly related to intravenous ciprofloxacin were reported in 15.8 percent of the courses; therapy was discontinued prematurely in 3 percent. Local reactions at the site of infusion were the most common, occurring in 4.4 percent of the courses. Changes in blood chemistry values (4.1 percent) included increases in alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. Reports of adverse effects referable to the gastrointestinal tract (3.0 percent) were primarily nausea and diarrhea. Central nervous system reactions (1.8 percent) included convulsive seizures, headache, and dizziness. In comparative trials, events considered probably or possibly drug related were reported for 17.3 and 13.6 percent of the ciprofloxacin- and ceftazidime-treated patients, respectively. The incidence of adverse events other than local reactions at the infusion site was not significantly different between the ciprofloxacin- and ceftazidime-treated patients (12.7 percent versus 11.0 percent, p greater than 0.2).
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PMID:Safety of intravenous ciprofloxacin. A review. 268 31

One hundred and sixty-four male patients suffering from urethral gonorrhoea were treated in an open randomised trial with either 250 mg (n = 85) or 500 mg (n = 79) ciprofloxacin administered in one tablet. Cure rates in both groups were 100%. Postgonococcal urethritis was observed in 31 of 85 (36%) patients in the first group, and in 21 of 79 patients (27%) in the second group. Side-effects were minor, occurring in four patients in the 250 mg group (4.7%) and in seven in the 500 mg group (8.9%). The side-effects consisted of nausea, diarrhoea and headache. Ciprofloxacin would appear to be a very effective drug in the treatment of urethral gonorrhoea in males.
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PMID:Treatment of uncomplicated gonococcal urethritis in men with two dosages of ciprofloxacin. 294 Dec 91

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)
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PMID:Ciprofloxacin and norfloxacin, two fluoroquinolone antimicrobials. 331 72

Ciprofloxacin is a new quinolone antimicrobial agent with activity against a broad spectrum of gram-negative and gram-positive organisms, including Pseudomonas aeruginosa and methicillin-resistant strains of staphylococci. The efficacy and safety results of 80 clinical studies of the oral form of ciprofloxacin are reported. Drug safety was assessed in 2236 courses in 2203 adult patients treated primarily in the United States. Data from 1676 courses were suitable for analysis of drug efficacy. The unit dose for most patients ranged from 250 mg to 750 mg (median, 500 mg), usually given every 12 hours. The duration of treatment ranged from 3 to 231 days (median, 10 days). Predominant among 1722 infections were those of the urinary tract (43%), skin structures (29%), and respiratory tract (19%); the remainder were bone and joint infections (5%), bacteremias (2%), and intra-abdominal (1%), gastrointestinal (1%), and pelvic infections (less than 1%). Signs and symptoms of infection resolved in 79% of all cases; a further 15% improved, and 5% failed to improve. Pathogens were eradicated in 89% of urinary tract infections and persisted in 5%; 80% of patients still had sterile urine at the 3-to 6-week follow-up. In 81% of nonurinary tract infections, pathogens were eradicated; they persisted in 11%, and superinfection occurred in less than 5%. After treatment, 89% of the 2253 causative organisms were eradicated and 2% were reduced to clinically insignificant counts; 8% persisted. Of 411 isolates of P. aeruginosa, 77% were eradicated, as were 97% of 421 Escherichia coli and 80% of 248 Staphylococcus aureus isolates. Also eradicated were 95% of 166 Klebsiella, 96% of 139 Proteus mirabilis, 100% of 20 other Proteus, 94% of 123 Enterobacter, 100% of 68 Haemophilus influenzae, 96% of 49 Citrobacter, 89% of 45 Serratia, 95% of 41 Streptococcus pneumoniae, 91% of 43 Salmonella, 100% of 38 Morganella morganii, and 100% of 35 Providencia isolates. Adverse reactions were judged probably or possibly drug-related in 14.8% of courses; drug treatment had to be stopped prematurely in 3.5%. The most frequent reactions were gastrointestinal complaints (chiefly nausea, diarrhea, and vomiting), metabolic disorders (elevated SGOT, SGPT, serum creatinine, or blood urea nitrogen), and nervous system effects (dizziness, light-headedness, restlessness, tremor, and headache). Crystalluria, judged to be related to ciprofloxacin, occurred in two patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial. 336 Sep 68

This review summarizes adverse reactions probably or possibly attributable to oral ciprofloxacin therapy in worldwide clinical experience involving over 6500 patients. In Europe and Japan the overall incidence of adverse reactions amongst patients receiving ciprofloxacin is reported to be 3.0% and 6.5%, respectively. An increased incidence (13.4%) has been reported from the U.S.A., possibly relating to the use of higher dosages. Very few reactions have necessitated withdrawal of treatment. The most common adverse effects involve the gastro-intestinal system (2-8% of patients treated) and usually comprise nausea, vomiting, diarrhoea and abdominal discomfort. CNS effects are seen in 1-4% of patients but are usually minor dizziness or mild headache only. Hypersensitivity reactions, most commonly skin rashes or pruritus, affect about 1% of patients. There is little evidence of significant haematological or biochemical toxicity, other than a few reports of transient neutropenia and the finding, in a minority of clinical studies, of equally transient, usually trivial and invariably reversible elevations of serum aminotransferases. Serious, ciprofloxacin-related toxicity has been observed in only three patients: one who developed pseudomembranous colitis, another who developed interstitial nephritis and a third who had a grand-mal convulsion during concomitant administration of theophylline. Ciprofloxacin appears to have an excellent safety profile.
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PMID:Ciprofloxacin: an overview of adverse experiences. 354 45

In a prospective, randomized, double-blind trial, ciprofloxacin (250 mg orally, twice daily) was compared with cinoxacin (500 mg orally, twice daily) in 60 patients with urinary tract infections. Most patients were women with uncomplicated urinary tract infections. Escherichia coli was the most common isolate (36 patients). Clinical and microbiologic cure occurred in 20 of 24 (83 percent) evaluable patients treated with ciprofloxacin, compared with 15 of 21 (71 percent) evaluable patients treated with cinoxacin. Ciprofloxacin was well tolerated and had a low incidence of minor side effects that included Candida vaginitis, headache, and gastrointestinal intolerance. Relapse or failed therapy was not associated with the development of resistance.
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PMID:Ciprofloxacin versus cinoxacin in therapy of urinary tract infections. A randomized, double-blind trial. 355 49

Eighty-three patients with serious urinary tract infections were treated with oral ciprofloxacin. Of these patients, 79 were hospitalized, and 41 had known structural or neurologic abnormalities of the urinary tract. The most common pathogens were members of the family Enterobacteriaceae (MICs, less than or equal to 0.06 microgram/ml), Pseudomonas aeruginosa (MICs, 0.13 to 2 micrograms/ml), and Enterococcus faecalis (MICs, 0.5 to 2 micrograms/ml). Sixty-eight patients were able to be evaluated for determining efficacy; all responded symptomatically, and all urinary pathogens were eradicated on days 3 to 5 of treatment. Five patients, who were treated for a relatively short duration (2 to 10 days), relapsed 5 to 9 days posttreatment. Six patients became colonized with yeasts during treatment, and seven patients developed bacterial reinfections 5 to 9 days posttreatment. All patients whose infections relapsed or who developed infections with new organisms had neurogenic bladders, structural abnormalities of the genitourinary tract, or urinary catheters. There was no instance of bacteria developing resistance during treatment. Ciprofloxacin probably caused nausea with or without vomiting in 7 of the 83 patients, headache in 3 patients, and mild elevation of hepatic enzymes in 2 patients; other adverse reactions were observed but were probably not drug related. Oral ciprofloxacin was effective and safe for the treatment of serious urinary tract infections caused by a variety of bacterial pathogens.
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PMID:Efficacy and safety of oral ciprofloxacin for treatment of serious urinary tract infections. 356 44

Two hundred and forty two patients of enteric fever were treated at Command Hospital (EC) Calcutta, during the period 1989-90. The mean age of the patients was 28.4 (range 2-60) years and 119 (49.2%) of them were males. Fever (100%), headache (55%), diarrhoea (25.2%), intestinal bleeding (2.9%) and icterus (3.7%) were the main presenting features. Blood cultures were positive in 216 (%) patients. A majority of the isolates were found to be resistant to all four commonly used drugs for enteric fever i.e. chloramphenicol, ampicillin, cotrimoxazole and furazolidone. The commonest phage type found in the resistant strains was 51 (biotype-1). Two plasmids of 14 and 120 kd size were detected in the resistant strains but not in the sensitive strains. Clinical response to gentamicin was not satisfactory in spite of all strains showing in vitro sensitivity. Ciprofloxacin proved to be a safe and effective drug for the treatment of multidrug resistant enteric fever.
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PMID:The anatomy of an epidemic (the final report on an epidemic of multidrug resistant enteric fever in eastern India). 834 45


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