Intravenous/oral ciprofloxacin versus intravenous ceftazidime in the treatment of serious gram-negative infections of the skin and skin structure.

A prospective, randomized, non-blind comparison of sequential intravenous/oral ciprofloxacin with parenteral ceftazidime as treatment for serious infections of the skin and skin structure caused by susceptible gram-negative organisms was conducted. For mixed gram-positive or anaerobic infections, concurrent therapy with vancomycin or anti-anaerobic agents was used. The mean duration of therapy was 25 days for the 32 evaluable ciprofloxacin-treated patients and 19 days for the 19 evaluable ceftazidime-treated patients. Overall response was "cure" in 24 of 32 (75 percent) ciprofloxacin-treated patients and 11 of 19 (58 percent) ceftazidime-treated patients (0.01 less than p less than 0.05). Ciprofloxacin eradicated 36 of 46 (78 percent) pathogens and ceftazidime 21 of 29 (72 percent) pathogens. Superinfections occurred in nine of 32 (28 percent) ciprofloxacin patients and in two of 19 (11 percent) ceftazidime patients (0.01 less than p less than 0.05). Adverse reactions requiring cessation of therapy occurred in two of 32 (6 percent) ciprofloxacin patients and in one of 19 (5 percent) ceftazidime patients. There was one death in each group; neither was due to the infection or antimicrobial therapy. Chronic infection was a significant risk factor for failure in both groups. Ciprofloxacin was as effective and safe as ceftazidime for serious infections of the skin and skin structure.