Experience with ciprofloxacin in the treatment of various infections caused mainly by Pseudomonas aeruginosa.

Ciprofloxacin, a new quinolone carboxylic acid derivative with an enhanced spectrum of activity including P. aeruginosa, was given to 42 patients, 26 males and 16 females, ranging in age from 12 to 75 years. They were suffering from upper urinary tract infection (15), abscesses (hepatic 1, intra-abdominal 5, retroperitoneal 1, soft tissue, deep soft tissue infection (9), chronic otitis media in exacerbation (3), chronic osteomyelitis in exacerbation (3), bronchopneumonia (3) and otitis externa (1). Pathogens included P. aeruginosa (29), E. cloacae (7), P. mirabilis, E. coli (3) and S. marcescens (1), with MICs for ciprofloxacin ranging from 0.003-2 micrograms/ml. Over half of the isolates were multiresistant, also to amikacin, with almost all the Pseudomonas strains resistant to carbenicillin and the ureidopenicillins. In 21 patients ciprofloxacin was given orally at a dose of 500 mg or 750 mg 12-hourly, in 5 patients i.v. at a dose of 200 mg 12-hourly; while in 16 patients treatment was started i.v. and was continued by the oral route. Seventeen patients were given ciprofloxacin for 7-14 days, 5 for 15-22 days, 4 for 23-28 days, 8 for 29-42 days, and 8 for greater than 42 days. Treatment response was considered clinically as cure in 30 (71.5%) patients, improvement in 8 (19%) and failed in 4 (9.5%). Pathogens were eradicated during treatment in 34 (81%), persisted in 8 (19%) and recurred in 11 (26.2%) patients. Development of resistance was observed in one patient only. Adverse reactions in 12 patients were minimal and self-limited. It was concluded that ciprofloxacin is a very promising new antimicrobial which merits further clinical trials in systemic infections.