Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-three patients undergoing autologous bone marrow transplantation received antimicrobial prophylaxis with ciprofloxacin with or without erythromycin and low dose intravenous amphotericin B. Eight patients remained afebrile throughout the neutropenic period. All other patients had one or more febrile episodes. The median time to fever after the onset of neutropenia was 7 days. There were no gram-negative organisms isolated from blood cultures during any of these episodes whereas gram-positive organisms were isolated in 28. There was one death in this series associated with sepsis. The use of low-dose prophylactic parenteral amphotericin did not prevent the subsequent successful use of full dose amphotericin for antibiotic-resistant fever. Ciprofloxacin effectively prevents gram-negative sepsis. The addition of erythromycin does little to prevent gram-positive sepsis. The use of regimens with agents with activity against gram-positive organisms is appropriate initial treatment of all febrile neutropenic episodes.
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PMID:An assessment of the efficacy of antimicrobial prophylaxis in bone marrow autografts. 176 71

Treatment of infectious complications with ciprofloxacin in 65 patients provided good and satisfactory results in 67.7 and 20.0 per cent of the cases, respectively. The drug was efficient in sepsis, urogenital infections, respiratory infections and postoperative purulent complications. Ciprofloxacin showed a broad antibacterial spectrum. 96.3 per cent of the isolates belonging to aerobic organisms causing purulent inflammatory processes, including those with high antibiotic resistance levels, such as Pseudomonas spp., Proteus spp., Klebsiella tribe and Staphylococcus aureus were sensitive to the drug. In its antibacterial spectrum ciprofloxacin was similar to ofloxacin. The advantage of ciprofloxacin is its possible use not only orally but also intravenously. Adverse reactions to ciprofloxacin were observed in 5 (7.7 per cent) out of the 65 patients. In two cases discontinuation of the drug use was required. The use of ciprofloxacin in treatment of infectious complications in oncological patients is promising.
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PMID:[Ciprofloxacin in the treatment of infections in oncology patients]. 209 40

Forty consecutive neutropenic patients with acute leukemia receiving oral ciprofloxacin (500 mg twice daily) and ketoconazole (200 mg daily) for selective intestinal decontamination were compared retrospectively with 33 comparable patients treated with polymyxin E (1,500,000 U x 3/day) and nystatin (1,000,000 U x 3/day). The incidence of febrile episodes was slightly lower in ciprofloxacin treated patients (87.5% vs 100%). No gram-negative sepsis was observed in this group compared with seven cases in patients receiving polymyxin E (p less than 0.01). Furthermore, eight patients in ciprofloxacin group (20%) had gram-positive sepsis, compared with five (15.5%) in the polymyxin E group. The incidence of documented fungal infections was similar in the two groups. Ciprofloxacin appears to be an effective agent for the prevention of gram-negative infections in granulocytopenic patients with acute leukemia, but may contribute to a shift in the type of infections in these patients towards those caused by gram-positive microorganisms, intrinsically fairly sensitive or with acquired drug resistance.
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PMID:Ciprofloxacin for infection prophylaxis in granulocytopenic patients with acute leukemia. 209 96

Ciprofloxacin is the most potent post-marketing fluoroquinolone. In vitro activity and pharmacokinetic properties of this agent, together with clinical trials of the drug may be very promising in the treatment of severe infections, especially when the bacteria involved are resistant to other conventional agents. We performed an open clinical trial of this agent in hospitalized patients with severe infections in a university hospital in Bangkok, Thailand. A total of 25 patients were enrolled on the basis of clinical diagnosis of severe bacterial infections. Six of these patients were dropouts (3 of which proved to be non-bacterial infections, 2 patients each had only anaerobic infection and nocardiosis. One suffered from a severe psychotic attack). The remaining 19 patients were evaluated. There were 12 males and 7 females, the age ranged from 13 to 77 years old (43.2 +/- 20.1). Most had severe underlying illnesses (17 out of 19). There were 23 infections in 19 patients. Septicemia was the most common infection treated. Other infections included complicated urinary infection, upper respiratory tract infection, skin/skin structure infection. P. aeruginosa was the most common pathogen infected. Other organisms were E.coli, Enterobacter, P.mirabilis, S.aureus, A.antitratus and mycobacterium. Ciprofloxacin was given as an initial 100 mg twice daily as intravenous infusion, and this was switched to an oral form of 500 mg b.i.d./at approximately day 4 to day 6. The overall cure rate was 68 per cent. There were 2 improvements, 2 relapses/reinfections and one failure. Toxic effect included one psychotic attack necessitating discontinuation of the drug. Other adverse drug reactions were mild and transient. These included elevation of transaminase and LDH.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ciprofloxacin in severe infections. 223 Jun 26

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 were Escherichia 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.
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PMID:Serum levels of ciprofloxacin after single oral doses in patients with septicemia. 262 Jun 71

The therapeutic efficacy and safety of ciprofloxacin was studied in 30 patients with Pseudomonas aeruginosa infections. In 20 patients ciprofloxacin was given alone and in 10 patients (including 8 compromised hosts) in combination with an aminoglycoside (9) or azlocillin (1). Ciprofloxacin was given in doses of 500 mg orally or 200-300 mg i.v. every 12 h. In patients receiving only ciprofloxacin clinical cure with eradication of bacteria was obtained in 15 patients (75%) with infections of bone and joint (6), skin and soft tissue (4), lung (2), middle ear (2) and CSF (1). Two patients with lymphoma and Pseudomonas aeruginosa pneumonia died. In patients receiving combination therapy a definite therapeutic success was achieved in four (40%). Three patients with Pseudomonas aeruginosa septicemia died. In seven patients nine bacterial strains with decreasing susceptibility of ciprofloxacin (increase in MIC from less than or equal to 0.5 micrograms/ml to 2-16 micrograms/ml) were selected (6 Pseudomonas aeruginosa, 1 Enterobacter cloacae, 1 Serratia marcescens, 1 Staphylococcus aureus). Ciprofloxacin was well tolerated. This new quinolone seems to be suitable for single drug treatment of Pseudomonas aeruginosa infections in patients with normal host defense mechanisms, while its therapeutic potential in compromised hosts requires further evaluation.
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PMID:Use of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections. 294 Dec 89

Ciprofloxacin is a new 4-quinolone antibacterial agent with an extended antibacterial spectrum, enhanced potency and the ability to produce therapeutic serum, tissue and urine concentrations after oral administration. Unlike earlier 4-quinolones, it is active against gram-positive cocci and opportunistic organisms such as Pseudomonas aeruginosa. This overview demonstrates that the oral formulation has been shown to be clinically effective in a broad range of urinary and respiratory infections, gonorrhoea, gastro-intestinal infections including typhoid fever, surgical infections, skin and soft tissue sepsis and in a variety of infections caused by Pseudomonas aeruginosa, notably cystic fibrosis. Adverse reactions are infrequent and in almost every case have proved mild and transient. Ciprofloxacin has great potential for the oral therapy of infections which have traditionally required parenteral chemotherapy.
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PMID:Overview of clinical experience with ciprofloxacin. 301 31

Infective complications not only remain the major factor in preventing a large proportion of cancer patients from achieving a complete remission, but also greatly influence the outcome of immunosuppressed transplant recipients and are a prominent problem in subjects affected by AIDS. We report the results of 73 patients, 54 males and 19 females with a mean age of 61.4 +/- 15.1 years affected by solid cancer (64 pts), AIDS (6 pts) or with kidney transplant (3 pts), treated with ciprofloxacin 250 mg bid (21 pts) or 500 mg bid (52 pts) for respiratory tract infections (41 cases), urinary tract infections (22), septicemia (5) or other infections (5). The mean course of therapy was 9.6 +/- 5.7 days and led to a complete resolution of symptoms in 66 (90.4%) patients, improvement in 6 (8.2%), while the clinical picture was unaffected in 1 (1.4%). Candida superinfection occurred in one case and only four patients experienced side effects. Ciprofloxacin results to be an effective antibacterial agent in a high risk population.
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PMID:Treatment of infections in non-neutropenic patients with cancer, AIDS, or renal transplant using ciprofloxacin. 304 28

Ciprofloxacin, azlocillin, and tobramycin, used alone and in combination, were studied in a model of lethal pseudomonas sepsis in rats. Ciprofloxacin alone at all doses studied and tobramycin alone at the highest dose reduced mortality significantly compared with saline controls. In contrast, survival was not improved with either azlocillin alone at all doses studied or lower doses of tobramycin alone. The combination of ciprofloxacin and azlocillin was synergistic in rats with systemic pseudomonas infection. Ciprofloxacin was rapidly absorbed, and effective levels persisted for 1-4 hr relative to the dose administered. These data suggest that ciprofloxacin may be a potent agent, either alone or in combination with azlocillin, in the treatment of severe pseudomonas infections.
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PMID:Comparative efficacy of ciprofloxacin, azlocillin, and tobramycin alone and in combination in experimental Pseudomonas sepsis. 310 31

We injected multiple doses of intravenous ciprofloxacin over 10 minutes every 12 hours for 1 week to nine healthy subjects, while three other subjects received placebo. Ciprofloxacin doses of 25, 50, and 75 mg were evaluated with a 1-week washout between each dose level. Mean (+/- SD) terminal excretion t1/2S were 3.56 +/- 0.66, 4.15 +/- 0.68, and 3.46 +/- 0.42 hours for the 25, 50, and 75 mg doses. Serum clearances were 35.4 +/- 6.8, 31.8 +/- 3.0, and 31.3 +/- 5.4 L/hr/1.73 m2 for these doses. Urine concentrations remained above the minimal inhibitory concentration of most urinary tract pathogens for the full 12-hour dosing interval at each dose. Renal clearance accounted for 65% to 70% of the serum clearance, but because biologically active renally excreted metabolites have been identified, our values exceed the true values. The doses of ciprofloxacin we intravenously injected were well tolerated and appeared adequate for treatment of urinary tract infections. For serious hospital-acquired sepsis, however, larger doses should be evaluated.
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PMID:Multiple-dose ciprofloxacin dose ranging and kinetics. 315 30


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