Preliminary evaluation of ciprofloxacin, a new 4-quinolone antibiotic, in the treatment of febrile neutropenic patients.

Twenty-four episodes of fever in neutropenic patients with haematological malignancy were treated with ciprofloxacin. In 13 episodes ciprofloxacin was used after failure of first-line antibiotic therapy, and in 11 episodes because of a history of allergy to the proposed first line antibiotics. Improvement or temporary improvement was seen in 64% of patients with evaluable infection. Fifty per cent of patients with bacteraemia improved. Resistance to ciprofloxacin developed in strains of staphylococci and streptococci, but Gram-negative organisms were generally extremely sensitive to the antibiotic. One patient developed a severe photosensitivity rash but there were no other adverse reactions. Preliminary pharmacokinetic data were obtained following intravenous infusion of 400 mg of ciprofloxacin in five patients. The mean plasma half-life was 3.6 +/- 1.0 h and the mean plasma clearance was 8.42 +/- 2.5 ml/min/kg.