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PMID: 8186542 Published · ppublish English Journal Article Review

Ciprofloxacin. A review of its pharmacological profile and therapeutic use in the elderly.

Drugs & aging ·Vol. 4 ·No. 2 ·1994-02-00 ·Pages 145-73

Wiseman LR, Balfour JA

Abstract

Ciprofloxacin belongs to the fluoroquinolone class of antimicrobial agents which primarily inhibit bacterial DNA gyrase. It is effective after oral or intravenous administration, demonstrating potent antibacterial activity against most Gram-negative, and many Gram-positive bacteria. Although most bacterial strains have remained susceptible to the drug, low rates of resistance have been observed in some strains of Pseudomonas aeruginosa and enterococci and higher rates in methicillin-resistant Staphylococcus aureus. Ciprofloxacin attains concentrations in most tissues and body fluids sufficient to inhibit the majority of susceptible pathogens. Its pharmacokinetic profile in the elderly (> or = 65 years) is broadly similar to that reported in younger persons, although plasma concentrations are higher, and renal clearance is decreased in elderly persons. Ciprofloxacin is an effective treatment for those infections most common in elderly patients, including infections of the urinary tract, lower respiratory tract, skin and soft-tissues, and bone and joints, and is an effective agent for prophylaxis in transurethral surgery. Orally administered ciprofloxacin appeared to be at least as effective as alternative orally administered antimicrobial agents (trimethoprim, cotrimoxazole [trimethoprim/sulfamethoxazole], amoxicillin, amoxicillin/clavulanic acid) and also as effective as various parenteral agents (ceftriaxone, cefamandole, ceftazidime, cefotaxime) in a small number of comparative clinical trials. However, further studies are needed to clarify the comparative efficacy of ciprofloxacin with that of other oral and parenteral agents in the elderly. Initial trials have also indicated therapeutic efficacy of oral ciprofloxacin in malignant external otitis and bacterial prostatitis. Nevertheless, with its good tolerability profile and potent antimicrobial activity following oral administration, ciprofloxacin appears to offer a valuable alternative for treating various acute and chronic infections in elderly patients. Causative pathogens are frequently multiresistant in this patient group, and ciprofloxacin avoids or minimises the need for parenteral therapy.

MeSH Terms
Bacterial Infections/drug therapy Ciprofloxacin/pharmacokinetics,pharmacology,therapeutic use Drug Interactions Humans Premedication Respiratory Tract Infections/drug therapy Urinary Tract Infections/drug therapy
Chemicals
Ciprofloxacin
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Wiseman L R
Adis International Limited, Auckland, New Zealand.
Balfour J A
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Article Info
Journal
Drugs & aging
Abbr.
Drugs Aging
ISSN
1170-229X
DOI
10.2165/00002512-199404020-00007
Published
1994-02-00
Pages
145-73
Language
English
Region
New Zealand
NLM ID
9102074
Subset
IM
External Links
PubMed source DOI: 10.2165/00002512-199404020-00007 View journal details
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