Efficacy, safety, and potential economic benefits of oral ciprofloxacin in the treatment of infections

Abstract

Ciprofloxacin is a new 4-quinolone carboxylic acid derivative with a broad spectrum of activity against gram-positive and gram-negative bacteria, chlamydiae, rickettsiae, and related organisms. The drug has been administered orally to 2,018 patients, primarily in the United States. In open trials oral ciprofloxacin has been shown to constitute effective therapy for osteomyelitis, gonorrhea, and infections of the urinary and gastrointestinal tracts, respiratory tree, and skin and soft tissues. In controlled comparative trials, most of which were doubly blinded, oral ciprofloxacin was equal in terms of safety and therapeutically equal or superior to oral trimethoprim-sulfamethoxazole in urinary and gastrointestinal infections, to oral ampicillin in respiratory infections, and to parenteral cefotaxime in skin and soft tissue disease. Adverse reactions were infrequent and generally mild. The emergence of resistance was encountered rarely; the organisms implicated were usually those for which initial minimal inhibitory concentrations were high, albeit in the sensitive range (such as Pseudomonas aeruginosa). Ciprofloxacin potentiates the toxicity of theophylline. Concurrent administration of antacids may diminish gastrointestinal absorption of the drug.